Comparison of uptake of 99mTc-MIBI, 99mTc-tetrofosmin and 99mT-Q12 into human breast cancer cell lines

International Nuclear Information System (INIS)

Yong, M. de; Bernard, B.F.; Breeman, W.A.P.; Ensing, G.; Benjamins, H.; Bakker, W.H.; Visser, T.J.; Krenning, E.P.

1996-01-01

Technetium-99m hexakis-2-methoxyisobutyl-isonitrile (MIBI), 99m Tc-tetrofosmin and 99m Tc-Q12 were all introduced for myocardial imaging but found additional applications as they are taken up by different tumours, enabling imaging of these lesions in patients. The aim of this study was to compare the uptake characteristics of these compounds in vitro in the human adenocarcinoma breast cell lines MCF-7 and ZR-75. It was shown that 99m Tc-MIBI had the highest cellular uptake (15.9%±0.5% dose/mg protein after 60 min in MCF-7, and 14.2%±0.4% dose/mg protein in ZR-75), followed by 99m Tc-tetrofosmin (6.8%±0.6% dose/mg protein in MCF-7, and 8.2%±0.2% dose/mg protein in ZR-75) and 99m TC-Q12 (3.2%±0.1% dose/mg protein in MCF-7, and 3.5%±0.3% dose/mg protein in ZR-75 cells). For all three compounds tenfold differences in specific activity did not influence total cell-associated radioactivity. Uptake of 99m Tc-MIBI and 99m Tc-tetrofosmin was obviously lower at 4 C than at 37 C, whereas 99m Tc-Q12 uptake showed only slight temperature dependence. When uptake was compared in cells grown to different cell densities (1 mg/ml cellular protein versus 0.3 mg/ml), no differences in uptake were detected when uptake was corrected for the amount of cellular protein present in the dishes. Furthermore, for all compounds it was shown that cellular radioactivity decreased rapidly after washing. Apart from the differences in cellular uptake of the three compounds after 60 min, no differences in residual cellular radioactivity after washing were found between the different compounds when expressed as a percentage of their 60-min uptake, suggesting that the efflux process of the radiolabelled compounds was similar. The differences in cell-associated activity after 60 min were thus presumably caused by differences in uptake. (orig./MG)

Exanthema after a stress Tc-99m sestamibi study: continue with a rest sestamibi study?

DEFF Research Database (Denmark)

Hesse, Birger; Vinberg, Niels; Mosbech, Holger

2011-01-01

Purpose:  A mild allergic reaction assumed to be caused by injection of Tc-99m sestamibi for a stress myocardial perfusion imaging (MPI) is presented. We want to discuss the risk involved in completing the MPI with another sestamibi injection, and the precautions and possible treatment in case...... of a further reaction. Material and methods:  A patient experienced a maculo-papular exanthema, i.e. a mild, probably allergic, adverse event (AE) after a stress MPI including administration of a dose of Tc-99m sestamibi. A rest MPI was needed to decide whether coronary bypass surgery should be performed...

A review of 99mTc labeled myocardial imaging agents for tumor-positive imaging

International Nuclear Information System (INIS)

Xing Shian; Zhang Yongxue; An Rui

2002-01-01

The tumor-positive imaging with high sensitivity and specificity was useful in primary tumor and recurrences and metastases. The 99m Tc labeled myocardial imaging agents are easily available and stable and the radiochemical purity is high. 99m Tc is the preferred choice in routine works because its physical properties. The preparation, quality control, mechanism of accumulation and the clinical use of 99m Tc-sestamibi, 99m Tc-tetrofosmin, 99m Tc-furifosmin, and 99m Tc-N-NOET were reviewed

Myocardial uptake characteristics of three 99mTc-labeled tracers for myocardial perfusion imaging one hour after rest injection

International Nuclear Information System (INIS)

Manka-Waluch, A.; Palmedo, H.; Reinhardt, M.J.; Joe, A.Y.; Manka, C.; Guhlke, S.; Biersack, H.J.; Bucerius, J.

2006-01-01

99m Tc-tetrofosmin and 99m Tc-sestamibi are approved tracers for myocardial perfusion studies. Recently, a 99m Tc-methoxyisobutylisonitrile (MIBI) preparation from a different manufacturer ( 99m Tc-cardiospect-MIBI) has been introduced to the market. Therefore, the aim of this study was the evaluation of 99m Tc-tetrofosmin as well as of two different 99m Tc-labeled MIBI tracers with regard to differences in imaging quality under resting conditions. Sixty patients (mean age 63.8 years±1.25) with known or suspected coronary artery disease but without evidence of rest-ischemia were included. Twenty patients in each group were examined by a two-day-rest-stress protocol using the three 99m Tc-labeled tracers. Visual analysis of all images was performed by two experienced physicians blinded with regard to the applied tracer. Regions of interest (ROI) were defined over the heart, lung and whole body only in the rest imaging in order to calculate heart-to-lung, lung-to-whole body-, and heart-to-whole body-ratios. The heart-to-lung ratio was statistically significant higher for 99 m T c-cardiospect-MIBI as compared to 99m Tc-sestamibi as well as to 99m Tc-tetrofosmin. Furthermore, a significantly higher heart-to-lung ratio was found for 99m Tc-sestamibi as compared to 99m Tc-tetrofosmin. The heart-to-whole body-ratio and the lung-to-whole body-ratio were equivalent between all tracers. Visual analysis revealed only slight differences regarding image quality between all tracers. ROI analysis surprisingly revealed a significant higher myocardial uptake and consequently a higher heart-to-lung ratio for 99m Tc-cardiospect-MIBI. Whether this leads to a better visual image quality has to be evaluated in future studies with larger study populations as well as semiquantitative segmental analysis of the myocardial perfusion images. (author)

Testing the radiochemical purity of a radiopharmaceutical: study of {sup 99m}Tc-Tetrofosmin (Myoview); Controle de la purete radiochimique d`un radiopharmaceutique: etude du {sup 99m}Tc-Tetrofosmin (Myoview)

Energy Technology Data Exchange (ETDEWEB)

Moati, F.; Quartarone, C.; Jourdain, J.R.; Rizzo, N.; Dumont, A.; De Beco, V.; Ait Ben Ali, S.; Lours, S.; Piketty, M.L.; Izembart, M.; Goudou, C.; Lemercier, V.; Schlageter, M.H.; Moretti, J.L.; Progent, A. [Groupe de travail `Radiopharmaceutiques - Ile de France` (France)

1997-12-31

The goal of this study is to optimize the testing method of radiochemical purity (RCP) of {sup 99m}Tc-Tetrofosmin proposed by the Amersham Company: thin-layer chromatography (TLC); ITLC-SG support, migration on 15 Cm; acetone-dichloromethane mobile phase, (35/65, v/v), This technique allows separating the reduced-Tc (Rf = 0), the TcO{sub 4}{sup -} (Rf = 1), and in intermediary position (0.299m}Tc-Tetrofosmin. The results of RCP depend on working conditions, particularly, on the volume of deposit (10 to 20 {mu}l, expected). If the deposited is too small, the {sup 99m}Tc-Tetrofosmin does not migrate. With a volume of 20 {mu}l, the separation is weak and the peak width is un-resolvable. The results obtained correspond to the following operational conditions: migration on 8 cm; deposit of 8 to 10 {mu}l; no drying. In these conditions the peak of {sup 99m}Tc-Tetrofosmin is well singled out: migration Rf of 0.375 to 0.625. These results have been obtained by the analysis of radio-chromatographic peak. Every strip has been cut cm by cm and the activity was measured by a gamma counter. Repeatability of the method on a series of 8 tests is good: average RCP 93.22%, mean value = 93.24%. The reproducibility was realized by measuring directly by the activity-meter the activity corresponding to 3 identifiable peaks: Reduced Tc (Rf < 0.25), TcO{sub 4}{sup -} (Rf < 0.75), and {sup 99m}Tc-Tetrofosmin (0.25 < Rf < 0.75). On the 21 effectuated tests the inter-test RCP reproducibility was good: average value = 95.24%, CV = 2.07%, mean value 95.3%. In conclusion, the miniaturization improves the separation by Myoview (0.25 < Rf < 0.75), diminishes the migration time by a factor 4 and lowers the reactive cost of testing by 50%

Testing the radiochemical purity of a radiopharmaceutical: study of 99mTc-Tetrofosmin (Myoview)

International Nuclear Information System (INIS)

Moati, F.; Quartarone, C.; Jourdain, J.R.; Rizzo, N.; Dumont, A.; De Beco, V.; Ait Ben Ali, S.; Lours, S.; Piketty, M.L.; Izembart, M.; Goudou, C.; Lemercier, V.; Schlageter, M.H.; Moretti, J.L.; Progent, A.

1997-01-01

The goal of this study is to optimize the testing method of radiochemical purity (RCP) of 99m Tc-Tetrofosmin proposed by the Amersham Company: thin-layer chromatography (TLC); ITLC-SG support, migration on 15 Cm; acetone-dichloromethane mobile phase, (35/65, v/v), This technique allows separating the reduced-Tc (Rf = 0), the TcO 4 - (Rf = 1), and in intermediary position (0.2 99m Tc-Tetrofosmin. The results of RCP depend on working conditions, particularly, on the volume of deposit (10 to 20 μl, expected). If the deposited is too small, the 99m Tc-Tetrofosmin does not migrate. With a volume of 20 μl, the separation is weak and the peak width is un-resolvable. The results obtained correspond to the following operational conditions: migration on 8 cm; deposit of 8 to 10 μl; no drying. In these conditions the peak of 99m Tc-Tetrofosmin is well singled out: migration Rf of 0.375 to 0.625. These results have been obtained by the analysis of radio-chromatographic peak. Every strip has been cut cm by cm and the activity was measured by a gamma counter. Repeatability of the method on a series of 8 tests is good: average RCP 93.22%, mean value = 93.24%. The reproducibility was realized by measuring directly by the activity-meter the activity corresponding to 3 identifiable peaks: Reduced Tc (Rf 4 - (Rf 99m Tc-Tetrofosmin (0.25 < Rf < 0.75). On the 21 effectuated tests the inter-test RCP reproducibility was good: average value = 95.24%, CV = 2.07%, mean value 95.3%). In conclusion, the miniaturization improves the separation by Myoview (0.25 < Rf < 0.75), diminishes the migration time by a factor 4 and lowers the reactive cost of testing by 50%

99mTc-methoxy-isobutyl-isonitrile (sestamibi) imaging of malignant canine lymphoma

International Nuclear Information System (INIS)

Steyn, P.F.; Ogilvie, G.

1995-01-01

Technetium-99m methoxy-isobutyl-isonitrile (sestamibi) imaging of malignant canine lymphoma was performed in thirteen dogs 1 hour after intravenous injection of 99mTc-sestamibi at 13 MBq (0.35 mCi) per kilogram body weight. Abnormal tracer uptake was visualized in the liver, spleen, bone marrow, and mesenteric, inguinal, popliteal, sternal, cranial cervical and mandibular lymph nodes. Radiopharmaceutical uptake was also noted in a nasal mass. One large neoplastic renal mass did not have demonstrable sestamibi uptake. Other regions had no significant difference in the target:background ratios when compared with values from normal dogs (P > 0.05). 99mTc-sestamibi can be used to image malignant lymphoma, and has potential applications in the management of patients to document response to treatment and to stage of extent of disease

Comparison of the accumulation and efflux kinetics of technetium-99m sestamibi and technetium-99m tetrofosmin in an MRP-expressing tumour cell line

International Nuclear Information System (INIS)

Utsunomiya, K.; Su, Z.-F.; Ichise, M.; Ballinger, J.R.; Piquette-Miller, M.; Tang, W.; Rauth, A.M.

2000-01-01

The potential clinical use of technetium-99m labeled sestamibi (Tc-MIBI) and tetrofosmin (Tc-Tfos) to image tumours is currently being evaluated. In this study, the accumulation and efflux of Tc-MIBI and Tc-Tfos in the nasopharyngeal carcinoma cell line CNE-1 were examined in the presence or absence of various inhibitors of P-glycoprotein (PGP) and/or multidrug resistance associated protein (MRP) activity [GG918, PSC833, verapamil (Vrp), cyclosporin A (CsA) and buthionine sulfoximine (BSO)]. Reverse-transcriptase polymerase chain reaction analysis and immunodetection of the CNE-1 cells detected expression of MRP, MRP1 and MRP2 but not PGP. Tc-MIBI and Tc-Tfos accumulation was increased (P 2 times greater than for Tc-MIBI). However, no qualitative differences in inhibitors were seen between Tc-MIBI and Tc-Tfos. These results suggest that both Tc-MIBI and Tc-Tfos are substrates for the MRP transporter and that PSC833, Vrp, CsA and BSO but not GG918 can inhibit MRP activity. These results indicate that Tc-MIBI and Tc-Tfos may be suitable imaging agents for detecting MRP-mediated drug resistance in human cancers. (orig.)

A case of parathyroid carcinoma visualized on Tc-99m-sestamibi scintigraphy

International Nuclear Information System (INIS)

Aigner, R.M.; Fueger, G.F.; Lax, S.

1997-01-01

Recent studies indicate that Tc-99m-Sestamibi (MIBI, DuPont Pharma) is a useful tracer for detecting parathyroid adenomas. We present a patient with focal Tc-99m-MIBI uptake in parathyroid carcinoma which has only been described once before (1). Tc-99m-MIBI scintigraphy may be considered for diagnosing pathological parathyroid tissue. But presently the histopathological examination only allows the differentiation between adenoma and carcinoma. (orig.) [de

99m-technetium tetrofosmin and 99mTc-methylene diphosphonate in pre-surgical breast cancer

International Nuclear Information System (INIS)

Piperkova, E.; Gavrilov, I.; Timcheva, K.; Garanina, Z.; Aleksandrova, E.; Katerinski, K.; Dimitrova, M.

2004-01-01

Full text: The aim of this study was to assess the role of the Tc-99m Tetrofosmin (TF) in conjunction with Tc-99m methylenediphosphonate (MDP) in pre-surgical breast cancer (BC) staging. Thirty-six female patients, age range was 32-70 years (average 51.45 years), where the clinical examination, mammography (MG) and fine-needle aspiration cytology were inconclusive were subjected to Tc-99m TF Scintimammography (SMM). All the patients were examined in a specialized breast clinic by experienced surgeons and radiologists. Of the 36 patients, 24 had hyperdense breasts, 8 had undergone lumpectomy or mastectomy due to cancer in one of the breasts and were included in the present study because of suspicion of lesion in the contra lateral breast, 2 had palpable axillary lymph nodes (LN) but no palpable breast lump and 2 patients were of mastitis carcinomatosis. All biopsies were histopathologically verified 740 MBq of Tc-99m TF (Myoview-Amersham) was injected in the arm opposite to the side of the breast lesion. In patients with bilateral breast lesions (BL) radiopharmaceutical was injected in a pedal vein. Planar imaging in prone position was done 10-15 min later. Two lateral views of the left and right breasts including axilla were acquired followed by an anterior view in supine position with arm in an upright position so as to include both breasts and axillary region in the field of imaging view. Imaging was done using a large field of view single-head gamma camera (Diacam-Siemens) coupled with low-energy high-resolution collimator. In patients with locally advanced BC who were to receive pre-operative neo-adjuvant chemotherapy, cardiac GATED SPECT was also acquired using standard protocol. After few days, Tc-99m MDM scintimammography and whole-body bone scintigraphy was also performed. SMM, using the same acquisition protocol as with 99mTc-TF, was done 5-10 min after intravenous injection of 555-740 MBq 99mTc MDP. Standard WBBS was acquired two to three hours later. SMM

Scintigraphic findings on 99mTc-MDP, 99mTc-sestamibi and 99mTc-HMPAO images in Gaucher's disease

International Nuclear Information System (INIS)

Mariani, G.; Molea, N.; La Civita, L.; Porciello, G.; Lazzeri, E.; Ferri, C.

1996-01-01

We report here on the use of the lipophilic cationic complex technetium-99m sestamibi ( 99m Tc-MIBI), employed as an indicator of increased cellular density and metabolic activity, to evaluate Gaucher cell infiltrates in the bone marrow; 99m Tc-hexametazime ( 99m Tc-HMPAO) was also employed, as a pure indicator of lipidic infiltration in the bone marrow. A 67-year-old patient with known type 1 Gaucher's disease presented with a painful left hip and knee and difficulty in gait subsequent to traumatic fracture of the left femoral neck that had required implant of a fixation screw-plaque. Bone scan with 99m Tc-methylene diphosphonate revealed reduced uptake at the distal metaphyseal-epiphyseal femoral region. In addition, whole-body maps and spot-view acquisitions of the thighs and legs were recorded at both 30 min and 2.5 h after the injection of 99m Tc-MIBI: the scintigraphic pattern clearly showed increased uptake at several sites involved by Gaucher deposits in the bone marrow (both knees, with variable intensity in different areas), matching the bone changes detected by conventional x-ray. The target to non-target ratios slowly decreased with time, from an average value of 2.25 in the early scan to an average value of 2 in the delayed scan. The lipid-soluble agent 99m Tc-HMPAO exhibited a superimposable scintigraphic pattern of accumulation at the involved sites, though with lower target to non-target ratios (1.27-1.48). The results obtained in this patient suggest a potential role of 99m Tc-MIBI in the scintigraphic evaluation of Gaucher's lipid deposits in the bone marrow. If the results are confirmed in other patients, this radiopharmaceutical would offer clear advantages over 133 Xe because of its wider availability and greater practicality (i.v. administration of 99m Tc-MIBI versus inhalation of 133 Xe, and use of a single gamma camera instead of two as with 133 Xe). (orig.). With 3 figs

{sup 99m}Tc-sestamibi thyroid uptake in euthyroid individuals and in patients with autoimmune thyroid disease

Energy Technology Data Exchange (ETDEWEB)

Santos, Allan O. [Campinas State University, Division of Nuclear Medicine, Department of Radiology, School of Medical Sciences, Campinas (Brazil); Avenida Independencia, Piracicaba, Sao Paulo (Brazil); Zantut-Wittmann, D.E.; Tambascia, M.A. [Campinas State University, Division of Endocrinology, Department of Internal Medicine, School of Medical Sciences, Campinas (Brazil); Nogueira, R.O.; Etchebehere, E.C.S.C.; Lima, M.C.L.; Camargo, E.E.; Ramos, C.D. [Campinas State University, Division of Nuclear Medicine, Department of Radiology, School of Medical Sciences, Campinas (Brazil)

2005-06-01

We investigated the biokinetics of {sup 99m}Tc-sestamibi in the thyroid of euthyroid volunteers (EVs) and in patients with autoimmune thyroid diseases and determined the best time interval between {sup 99m}Tc-sestamibi injection and calculation of uptake. Forty EVs, 30 patients with Graves' disease (GD), 15 patients with atrophic Hashimoto's thyroiditis (AHT) and 15 patients with hypertrophic Hashimoto's thyroiditis (HHT) underwent {sup 99m}Tc-sestamibi thyroid scintigraphy. Dynamic images were acquired for 20 min, and static images were obtained 20 min, 60 min and 120 min post injection. Five-, 20-, 60- and 120-min uptake, time to maximal uptake (T{sub max}) and T{sub 1/2} of tracer clearance were calculated. Thyroid hormones and antibodies were measured. {sup 99m}Tc-pertechnetate uptake was investigated in GD patients. T{sub max} was approximately 5 min in all four groups. The mean T{sub 1/2} value for EVs was similar to the GD value and lower than the HHT and AHT values. The mean ({+-}SD) 5-min uptake was 0.13% ({+-}0.05%) for EVs. The 5-min uptake in GD was higher than that in EVs(P<0.001) and correlated with free thyroxine (r=0.54) and with {sup 99m}Tc-pertechnetate uptake (r=0.68). Uptake in HHT was higher than that in AHT (P=0.0003) and EVs (P=0.002). Uptake in AHT was lower than uptake in EVs (P=0.0001). Five minutes is the optimal time interval between {sup 99m}Tc-sestamibi injection and calculation of thyroid uptake. Five-minute uptake differentiates euthyroid individuals from GD patients. There is a high correlation between {sup 99m}Tc-sestamibi and {sup 99m}Tc-pertechnetate uptake in GD. The reduced {sup 99m}Tc-sestamibi uptake in AHT patients is probably due to glandular destruction and fibrosis. Inflammatory infiltrate and high mitochondrial density in thyrocytes possibly explain the increased uptake in GD and HHT. (orig.)

Evaluation of Tc-99m Sestamibi Scintimammography in the diagnosis of breast cancer patients

International Nuclear Information System (INIS)

Santa Cruz, R.; Morales, R.; Cano, R.; Aguilar, C.; Lopez, D.; Carlos, I.; Vigil, C.; Velarde, R.; Cisneros, F.

2002-01-01

Aim: The purpose of this study was to evaluate the diagnostic accuracy of Tc-99m Sestamibi scintimammography in the diagnosis of breast cancer in patients with palpable breast lesions and to determine the sensitivity, specificity, and positive and negative predictive values of this method. Material and methods: Fifty women (mean ± SD 46±9y) referred for a suspicious breast lesion on physical examination and abnormal or indeterminate mammogram underwent Tc-99m sestamibi scintimammography. Lateral prone and supine images were obtained at 15 and 60 minutes after administration of 25 mCi of the tracer, in the contralateral arm to the breast lesion. Subsequently, excisional biopsy and/or fine needle aspiration biopsy were performed. Scintigraphic results were compared with biopsies. Results: Breast cancer of 3 different types was histologically confirmed in 44 patients. Benign lesions were found in 6 patients. Tc-99m Sestamibi scintimammography was positive in 42/44 breast cancer patients (sensitivity 95,5%) and was negative in 5/6 patients with benign lesions (specificity 83,3%). Positive predictive value was 97,7% and negative predictive value was 71,4%. Conclusion: Tc-99m Sestamibi scintimammography is a valuable complementary tool in the diagnosis of breast palpable lesions, with a high sensitivity and specificity. We suggest its use as an adjuvant technique in patients with doubtful mammographies

Imaging recognition of inhibition of multidrug resistance in human breast cancer xenografts using 99mTc-labeled sestamibi and tetrofosmin

International Nuclear Information System (INIS)

Liu Zhonglin; Stevenson, Gail D.; Barrett, Harrison H.; Furenlid, Lars R.; Wilson, Donald W.; Kastis, George A.; Bettan, Michael; Woolfenden, James M.

2005-01-01

Background: 99m Tc-sestamibi (MIBI) and 99m Tc-tetrofosmin (TF) are avid transport substrates recognized by the multidrug resistance (MDR) P-glycoprotein (Pgp). This study was designed to compare the properties of MIBI and TF in assessing the inhibition of Pgp by PSC833 in severe combined immunodeficient mice bearing MCF7 human breast tumors using SPECT imaging. Methods: Animals with drug-sensitive (MCF/WT) and drug-resistant (MCF7/AdrR) tumors were treated by PSC833 and by carrier vehicle 1 h before imaging, respectively. Dynamic images were acquired for 30 min after intravenous injection of MIBI/TF using a SPECT system, FastSPECT. The biodistribution of MIBI and TF was determined at the end of the imaging session. Results: MCF7/WT in the absence and presence of PSC833 could be visualized by MIBI and TF imaging within 5 min and remained detectable for 30 min postinjection. MCF7/AdrR could be visualized only 2-5 min without PSC833 treatment but could be detected for 30 min with PSC833, very similar to MCF7/WT. MCF7/AdrR without PSC833 showed significantly greater radioactive washout than MCF7/WT and MCF7/AdrR with PSC833 treatment. PSC833 increased the accumulation (%ID/g) in MCF7/AdrR 3.0-fold (1.62±0.15 vs. 0.55±0.05, P<.05) for TF and 1.9-fold (1.21±0.04 vs. 0.64±0.05, P<.05) for MIBI but did not affect MCF7/WT. Conclusions: The feasibility of MIBI and TF for assessment of MDR expression and inhibition was demonstrated in mice through FastSPECT imaging. The results indicate that TF may be at least comparable with MIBI in recognizing Pgp expression and modulation

Comparison of Tc-99m-sestamibi-F-18-fluorodeoxyglucose dual isotope simultaneous acquisition and rest-stress Tc-99m-sestamibi single photon emission computed tomography for the assessment of myocardial viability

NARCIS (Netherlands)

De Boer, J; Slart, RHJA; Blanksma, Paulus; Willemsen, ATM; Jager, PL; Paans, AMJ; Vaalburg, W; Piers, DA

Dual isotope simultaneous acquisition single photon emission computed tomography (DISA SPECT) offers the advantage of obtaining information on myocardial perfusion using Tc-99m-sestamibi (Tc-99m-MIBI) and metabolism using F-18-fluorodeoxyglucose (F-18-FDG) in a single study. The prerequisite is that

Pharmacokinetic model of myocardial 99mTc-sestamibi washout

International Nuclear Information System (INIS)

Watanabe, Tsubasa; Monzen, Hajime; Mizowaki, Takashi; Hiraoka, Masahiro; Hara, Masatake

2013-01-01

Technetium-99m sestamibi ( 99m Tc-MIBI) scintigraphy has been reported to be a functional imaging tool for in vivo detection of mitochondrial dysfunction in myocardium and multidrug resistance-associated protein expression in tumors. The purpose of this study was to propose a clinically applicable pharmacokinetic model with metabolic equilibrium of 99m Tc-MIBI and to evaluate the accuracy of the model. For this study, eight healthy men received 99m Tc-MIBI scintigraphy. The planar images were obtained at 0.25, 0.5, 1, 2, 3, 4, 5, and 6 h after 99m Tc-MIBI injection. The measured time series 99m Tc-MIBI counts were fitted to our model by nonlinear regression analysis. The predictive performance of the model was determined by comparing the residuals between measured and predicted values. We obtained a good regression by fitting data from 0.25 to 6 h after 99m Tc-MIBI injection, with excellent correlation between measured and predicted 99m Tc-MIBI counts (R 2 =0.9792) and a slope near unity. The 95% confidence interval of the mean prediction error included 0, which means that the prediction was not significantly biased. The precision of the prediction was also excellent. Our model shows good predictive capacity, with favorable bias and accuracy. By comparing the predictive values of this model with measured values, mitochondrial 99m Tc-MIBI washout can be quantified. 99m Tc-MIBI washout rates are reported to be a promising method for evaluating cardiac function in patients with cardiac diseases and P-glycoprotein expression in tumor cells. Therefore, this quantification could be useful for mitochondrial functional imaging, especially in patients with cardiac diseases or tumors. (author)

Scintimammography with Tc-99m sestamibi in breast cancer

International Nuclear Information System (INIS)

Rajkovaca, Z.; Mijatovica, J.; Mikac, G.; Matavulj, A.; Kovacevic, P.; Ponorac, N.

2004-01-01

Full text: It is already known that breast cancer is the most common malignancy in women. Physical breast examination and mammography are currently the most recognized screening tools for detection of breast cancer. However, breast mammography has some limitations, especially in women with dense breast or in patients who have had surgery, radiotherapy or chemotherapy. The aim of this study was to investigate the role of Tc-99m Sestamibi scintimammography in the diagnosis of breast cancer. Forty-two women (median age= 46 years, range 21-78 years) were investigated. All had a thorough clinical examination, ultrasonography, mammography, determination of the level of tumor markers - CA15.3 and CEA, fine needle aspiration cytology (FNA) and scintimammography before surgery. The final diagnosis was determined by histopathological examination. For scintimammography, a dose of 740 MBq of Tc-99m sestamibi was injected into a foot vein followed by 10ml saline flush. Imaging was performed 10 minutes later in prone position; lateral views of the breasts and axilla were taken (10 minutes per view, matrix size 128x128, high resolution collimator). Anterior views of the breast and axillary areas were also acquired with patients in supine position. Delayed scintigraphy in prone position (lateral view) was done 60 minutes after injection. Focal accumulation of sestamibi in tumor on early and delayed scintigraphy was considered positive. The results of scintimammography were compared with histopathology. The histopathological results revealed malignancy in 33 (78.6%) and benign tumors in 9 (21.4%) cases. Scintimammography showed true positive findings in 31 (73.8%) patients having breast cancer. It was false negative in 2 cases (1 of invasive ductal carcinoma and 1 of invasive lobular carcinoma). All 5 cases with nonpalpable invasive ductal carcinoma and two cases with ductal carcinoma in-situ were positive on scintimammography. True negative findings with no focally increased

Evaluation of (99)  (m)TcN-MPO as a new myocardial perfusion imaging agent in normal dogs and in an acute myocardial infarction canine model: comparison with (99)  (m)Tc-sestamibi.

Science.gov (United States)

Bu, Lihong; Li, Renfei; Jin, Zhongnan; Wen, Xiaofei; Liu, Shuang; Yang, Baofeng; Shen, Baozhong; Chen, Xiaoyuan

2011-02-01

(99)  (m)TcN-MPO ([(99)  (m)TcN(mpo)(PNP5)](+): mpo = 2-mercaptopyridine oxide and PNP5 = N-ethoxyethyl-N,N-bis[2-(bis(3-methoxypropyl)phosphino)ethyl]amine) is a cationic (99)  (m)Tc-nitrido complex, which has favorable biodistribution and myocardial uptake with rapid liver clearance in Sprague Dawley rats. The objective of this study was to compare the biodistribution and pharmacokinetics of (99)  (m)TcN-MPO and (99)  (m)Tc-Sestamibi in normal dogs, and to evaluate the potential of (99)  (m)TcN-MPO as a myocardial perfusion agent in canines with acute myocardial infarction. Five normal mongrel dogs were injected intravenously with (99)  (m)TcN-MPO. Venous blood samples were collected via a femoral vein catheter at 0.5, 1, 2, 3, 4, 5, 10, 20, 30, 40, 60, and 90 min post-injection (p.i.). Anterior-posterior planar images were acquired by γ-camera at 10, 20, 30, 60, 90, and 120 min p.i. Regions of interest (ROIs) were drawn around the heart, liver, and lungs. The heart/liver and heart/lung ratios were calculated by dividing the mean counts in heart ROI by the mean counts in the liver and lung ROI, respectively. For comparison, (99)  (m)Tc-sestamibi was also evaluated in the same five dogs. The interval period between the two examinations was 1 week to eliminate possible interference between these two radiotracers. In addition, single positron emission computed tomography (SPECT) images in the canine infarct model were collected 24 h after myocardial infarction at 30 and 60 min after the administration of (99)  (m)TcN-MPO (n = 4) or (99)  (m)Tc-Sestamibi (n = 4). It was found that (99)  (m)TcN-MPO and (99)  (m)Tc-Sestamibi displayed very similar blood clearance characteristics during the first 90 min p.i. Both (99)  (m)TcN-MPO and (99)  (m)Tc-Sestamibi had a rapid blood clearance with less than 50% of initial radioactivity remaining at 1 min and less than 5% at 30 min p.i. (99)  (m)TcN-MPO and (99)  (m)Tc-Sestamibi both showed good

Role of 99mTc-sestamibi SPECT in accurate selection of primary hyperparathyroid patients for minimally invasive radio-guided surgery

International Nuclear Information System (INIS)

Rubello, Domenico; Massaro, Arianna; Cittadin, Silvia; Rampin, Lucia; Al-Nahhas, Adil; Boni, Giuseppe; Mariani, Giuliano; Pelizzo, Maria R.

2006-01-01

A prerequisite for optimum minimally invasive radio-guided surgery (MIRS) for primary hyperparathyroidism (PHPT) is the demonstration of significant uptake of 99m Tc-sestamibi in a parathyroid adenoma (PA). The aim of this study was to evaluate the clinical role or 99m Tc-sestamibi SPECT in selecting patients for this procedure. Fifty-four consecutive PHPT patients were evaluated by single-session 99m Tc-pertechnetate/ 99m Tc-sestamibi planar subtraction scintigraphy, followed by 99m Tc-sestamibi SPECT acquisition to localise hyperfunctioning PAs and assist in planning the surgical approach. Scintigraphy showed the presence of a solitary PA in 47/54 patients (87%) and two or more PAs in four patients (7.4%); it was negative in the remaining three patients (5.6%). The overall sensitivity of 99m Tc-sestamibi scintigraphy was 94.6%. In 7/54 patients, the PA was located deep in the para-oesophageal/paratracheal space. So far, 22 patients with scintigraphic evidence of a solitary PA (in four of whom the PA was located deep in the neck) have undergone successful MIRS using the low 37 MBq (1 mCi) 99m Tc-sestamibi dose protocol. Intraoperative quick parathyroid hormone (QPTH) assay demonstrated a fall in all 22 patients, thus confirming successful removal of the hyperfunctioning PA. No major surgical complications were observed. After a period of follow-up ranging between 6 and 27 months (median 13 months), no case of persistent/recurrent PHPT was recorded. When comparing the parathyroid to background (P/B) ratio measured at planar and SPECT preoperative scintigraphy with that measured intraoperatively with the gamma probe, a good linear correlation was found between the SPECT and the intraoperative gamma probe measurements (r=0.89; p 99m Tc-sestamibi SPECT is more accurate in predicting the intraoperative measurements with the gamma probe. In this respect, a preoperative 99m Tc-sestamibi SPECT acquisition should be recommended for better selection of PHPT patients in whom

Contribution of 99mTc-sestamibi scintigraphy by double phase in the exploration of hyperparathyroidism. Report of 20 cases

International Nuclear Information System (INIS)

Ghfir, I.; Ben Rais, N.

2008-01-01

Introduction 99m Tc-sestamibi parathyroid scintigraphy is a means of functional imaging allowing the exploration of hyperparathyroidism. The aim of our study is to demonstrate the utility of double-phase 99m Tc-sestamibi scintigraphy in the exploration of the secreting abnormal parathyroid gland. Materials and methods We report, through this work, the observation of 20 patients followed for a biologically ascertained hyperparathyroidism and explored, for the majority of them, by ultrasonography and/or computed tomography. All our patients benefited from a double-phase 99m Tc-sestamibi scintigraphy. Results On the 20 studied cases, the sex-ratio was equal to 1, two patients exhibited three high uptake foci at the 99m Tc-sestamibi scintigraphy, six exhibited two foci, twelve exhibited one parathyroid focus. In our series, 80% of patients exhibited secondary hyperparathyroidism and 20% exhibited a primary hyperparathyroidism. The pathologic exam revealed four cases of parathyroid adenoma and 16 parathyroid cases of hyperplasia. Discussion The double-phase 99m Tc-sestamibi scintigraphy contributes to the orientation and the improvement of the surgical attitude of the hyperparathyroidism, insofar as it could affirm the multiplicity of some adenomas, the diffuse form of some hyperplasia, and especially ectopic localization of the abnormal parathyroid gland

Comparison of Clinical Usefulness between N-13 Ammonia PET/CT and Tc-99m Sestamibi SPECT in Coronary Artery Disease

International Nuclear Information System (INIS)

Kong, Eun Jung; Cho, Ihn Ho; Chun, Kyung Ah; Won, Kyu Chang; Lee, Hyung Woo; Park, Jeong Sun; Shin, Dong Gu; Kim, Young Jo; Shim, Bong Seop

2008-01-01

N-13 ammonia uptake and retention in the myocardium is related to perfusion and metabolism. There are several potential advantages of N-13 ammonia positron emission tomography (PET) to detect myocardial ischemia, such as higher spatial resolution, greater counting efficiencies, and robust attenuation correction. But there are few reports comparing Tc-99m myocardial perfusion single photon emission tomography (MPS) and N-13 ammonia PET. We thus compared adenosine stress N-13 ammonia PET/CT and Tc-99m sestamibi MPS in patients with suspected coronary artery stenosis. Seventeen patients (male 13 : 63±11 years old) underwent adenosine stress N-13 ammonia PET/CT (Discovery ST, GE), Tc-99m sestamibi MPS (dual head gamma camera, Hawkeye, GE) and coronary angiography within 1 week. N-13 ammonia PET/CT and Tc-99m sestamibi MPS images were assessed with a 20-segment model by visual interpretation and quantitative analysis using automatic quantitative software (Myovation, GE). Both sensitivities and specificities of detecting an individual coronary artery stenosis were higher for N-13 ammonia PET/CT than Tc-99m sestamibi MPS (PET/CT: 91%/ 89% vs MPS: 65%/ 82%). N-13 ammonia PET/CT showed reversibility in 52% of segments that were considered non-reversible by Tc-99m sestamibi MPS. In the 110 myocardial segments supplied by the stenotic coronary artery, N-13 ammonia PET/CT showed higher count densities than Tc-99m MPS on rest study (p < 0.01), and the difference of count density between the stress and the rest studies was also larger on N-13 ammonia PET/CT. Adenosine stress N-13 ammonia PET/CT had higher diagnostic sensitivity and specificity, more reversibility of perfusion defects and greater stress/rest uptake differences than Tc-99m sestamibi MPS. Accordingly, N-13 ammonia PET/CT might offer better assessment of myocardial ischemia and viability

TC-99M tetrofosmin scintimammography in diagnosis of breast cancer patients

International Nuclear Information System (INIS)

Jaukovic, L.; Spaic, R.; Ajdinovic, B.

2004-01-01

99m Tc Tetrofosmin is a cationic complex developed for myocardial perfusion imaging, also used in diagnosis of patients with various malignancies. AIM of this study was to compare the diagnostic accuracy of 99m Tc-Tetrofosmin scintimammography (SMM) and X-ray mammography (MM) in detection of primary breast cancer. Method: Twenty eight female patients (mean age 52.4) with 30 breast lesions suspicious for malignancy were comprised in the study. In all patients were performed clinical investigation, MM, SMM and biopsy/surgery for final histopathologic diagnosis. Patients were injected by 555 MBq 99m Tc-Tetrofosmin intravenously, cubitaly, in the arm contralateral to the side of suspicious lesion. Seven minutes static scans or' at least 2.0 million counts were obtained. Planar images were acquired in left and right prone lateral view as well as in the supine position for an anterior view of chest and axilary region. SMM scans were interpreted visuely regarding the tracer' uptake in tumor and background tissue. SMM scans and mammograms of 30 lesions were compared to the definitive histopathologic (HP) using decision matrix and the results expressed as: sensitivity, specificity, accuracy, positive (PPV) and negative predictive value (NPV). HP analysis revealed 20 malignant and 10 benign lesions. Out of 23 patients with positive SMM scans 19 were related to breast cancer ( 15 invasive ductal, 1 invasive lobular, 1 papilllar, 1 colloid cancer and 1 cystosarcoma phyllodes-malignant type). Comparing the sensitivity in our group of patients, MM 'missed' four cancer lesions and SMM only one (1.0 cm invasive ductal carcinoma). Three of four false positive SMM results were obtained in patients with fibroadenomas bigger than 2.0 cm. Conclusion: SMM could play an important role as a part of the diagnostic protocol in patients with breast lesion suspicious for malignancy. This protocol is aimed to reduce the number of biopsies performed on benign lesions, and in the other hand to

Role of {sup 99m}Tc-sestamibi SPECT in accurate selection of primary hyperparathyroid patients for minimally invasive radio-guided surgery

Energy Technology Data Exchange (ETDEWEB)

Rubello, Domenico; Massaro, Arianna; Cittadin, Silvia; Rampin, Lucia [Istituto Oncologico Veneto (IOV), Nuclear Medicine Service - PET Unit, ' S. Maria della Misericordia' Hospital, Rovigo (Italy); Al-Nahhas, Adil [Hammersmith Hospital, Department of Nuclear Medicine, London (United Kingdom); Boni, Giuseppe; Mariani, Giuliano [University of Pisa Medical School, Regional Center of Nuclear Medicine, Pisa (Italy); Pelizzo, Maria R. [University of Padova Medical School, Department of Special Surgery, Padova (Italy)

2006-09-15

A prerequisite for optimum minimally invasive radio-guided surgery (MIRS) for primary hyperparathyroidism (PHPT) is the demonstration of significant uptake of {sup 99m}Tc-sestamibi in a parathyroid adenoma (PA). The aim of this study was to evaluate the clinical role or {sup 99m}Tc-sestamibi SPECT in selecting patients for this procedure. Fifty-four consecutive PHPT patients were evaluated by single-session {sup 99m}Tc-pertechnetate/{sup 99m}Tc-sestamibi planar subtraction scintigraphy, followed by {sup 99m}Tc-sestamibi SPECT acquisition to localise hyperfunctioning PAs and assist in planning the surgical approach. Scintigraphy showed the presence of a solitary PA in 47/54 patients (87%) and two or more PAs in four patients (7.4%); it was negative in the remaining three patients (5.6%). The overall sensitivity of {sup 99m}Tc-sestamibi scintigraphy was 94.6%. In 7/54 patients, the PA was located deep in the para-oesophageal/paratracheal space. So far, 22 patients with scintigraphic evidence of a solitary PA (in four of whom the PA was located deep in the neck) have undergone successful MIRS using the low 37 MBq (1 mCi) {sup 99m}Tc-sestamibi dose protocol. Intraoperative quick parathyroid hormone (QPTH) assay demonstrated a fall in all 22 patients, thus confirming successful removal of the hyperfunctioning PA. No major surgical complications were observed. After a period of follow-up ranging between 6 and 27 months (median 13 months), no case of persistent/recurrent PHPT was recorded. When comparing the parathyroid to background (P/B) ratio measured at planar and SPECT preoperative scintigraphy with that measured intraoperatively with the gamma probe, a good linear correlation was found between the SPECT and the intraoperative gamma probe measurements (r=0.89; p<0.01) but no correlation was found with planar scintigraphic data. Our preliminary data suggest that measurement of the P/B ratio by means of {sup 99m}Tc-sestamibi SPECT is more accurate in predicting the

Technetium-99m sestamibi: an indicator of breast cancer invasiveness

Energy Technology Data Exchange (ETDEWEB)

Scopinaro, F. (Section of Nuclear Medicine, Dept. of Experimental Medicine, Univ. ' La Sapienza' , Rome (Italy)); Schillaci, O. (Section of Nuclear Medicine, Dept. of Experimental Medicine, Univ. ' La Sapienza' , Rome (Italy)); Scarpini, M. (1st Inst. of Surgery, Univ. ' La Sapienza' , Rome (Italy)); Mingazzini, P.L. (1st Inst. of Surgery, Univ. ' La Sapienza' , Rome (Italy)); Di Macio, L. (Section of Nuclear Medicine, Dept. of Experimental Medicine, Univ. ' La Sapienza' , Rome (Italy)); Banci, M. (Section of Nuclear Medicine, Dept. of Experimental Medicine, Univ. ' La Sapienza' , Rome (Italy)); Danieli, R. (Section of Nuclear Medicine, Dept. of Experimental Medicine, Univ. ' La Sapienza' , Rome (Italy)); Zerilli, M. (1st Inst. of Surgery, Univ. ' La Sapienza' , Rome (Italy)); Limiti, M.R. (1st Inst. of Surgery, Univ. ' La Sapienza' , Rome (Italy)); Centi Colella, A. (Section of Nuclear Medicine, Dept. of Experimental Medicine, Univ. ' La Sapienza' , Rome (Italy))

1994-09-01

As recently shown, angiogenesis is the most reliable marker of breast cancer invasiveness. Unfortunately it must be assessed by immunohistochemistry on tissue specimens. We have used technetium-99m sestamibi, a marker of regional blood flow in other organs that often but not always images breast cancer, to assess the invasiveness of this tumour. Nineteen patients, ten with nodal metastases and nine without any metastases, were studied with [sup 99m]Tc-sestamibi scintigraphy before operation. Angiogenesis was quantitatively assessed by immunohistochemical staining of endothelia for factor VIII. All the node-positive (N+) patients at surgical revesion showed a positive [sup 99m]Tc-sestamibi scan of the primary tumour and all the N-patients were negative. Nine out of ten N+ and sestamibi-positive tumours showed more than 135 microvessels/mm[sup 2] and one showed 99 microvessels/mm[sup 2]; by contrast there were 71.6[+-]12.1 microvessels/mm[sup 2] in the nine N- and sestamibi-negative tumours. Our study suggests that [sup 99m]Tc-sestamibi is a marker of breast cancer invasiveness: its uptake is related to angiogenesis and, possibly, to oxidative metabolism of the tumour. (orig.)

A comparative study of 99Tcm-tetrofosmin and 99Tcm-MIBI myocardial imaging

International Nuclear Information System (INIS)

Zhao Kui; Chen Peng; Zhang Furong; Shen Wenhua

2001-01-01

Objective: To evaluate the value of 99 Tc m -tetrofosmin myocardial imaging for detecting coronary artery disease. Methods: Twenty-seven patients underwent 99 Tc m -tetrofosmin SPECT, twenty-six patients underwent 99 Tc m -MIBI SPECT; coronary angiography was performed on patients included in both groups (≥50% luminal diameter stenosis was considered significant coronary stenosis). Results: 99 Tc m -tetrofosmin produced high quality myocardial images from 30 min to several hours postinjection, the outlines of myocardial perfusion images provided by 99 Tc m -tetrofosmin imaging were clearly discernible. One-day exercise/rest 99 Tc m -tetrofosmin myocardial perfusion imaging was feasible and had a high sensitivity for detection of coronary artery disease. Sensitivities of 99 Tc m -tetrofosmin SPECT and 99 Tc m -MIBI SPECT for detecting coronary artery disease were 90% and 94%, respectively. The 95% confidence limits of both sensitivities were 68.65% - 98.77% and 72.33% - 99.86%, respectively; the positive predictive values of both imaging agents were 90.0% and 89.5%, respectively, the 95% confidence limits of those were 68.38% - 98.77% and 72.33% - 99.86% respectively; the positive predictive values of both imaging agents were 90.0% and 89.5%, respectively, the 95% confidence limits of those were 68.38% - 98.77% and 66.38% - 98.70%, respectively; efficiencies of both imaging agents were 85.2% and 88.5%, respectively. The 95% confidence limits of both efficiencies were 65.81% - 95.78% and 69.44 - 98.70%, respectively. The specificity for both imaging agents was 71% and 75%. There was no significant difference among above results (P > 0.05). No ECG abnormalities were found following the injection of 99 Tc m -tetrofosmin SPECT. There were no drug-related effects on blood pressure, heart rate and body temperature. This experiment failed to provide the negative predictive value of the myocardial perfusion imaging with 99 Tc m -tetrofosmin because that few patients with

Quantitative analysis of planar technetium-99m-sestamibi myocardial perfusion images using modified background subtraction

International Nuclear Information System (INIS)

Koster, K.; Wackers, F.J.; Mattera, J.A.; Fetterman, R.C.

1990-01-01

Standard interpolative background subtraction, as used for thallium-201 ( 201 Tl), may create artifacts when applied to planar technetium-99m-Sestamibi ( 99m Tc-Sestamibi) images, apparently because of the oversubtraction of relatively high extra-cardiac activity. A modified background subtraction algorithm was developed and compared to standard background subtraction in 16 patients who had both exercise-delayed 201 Tl and exercise-rest 99m Tc-Sestamibi imaging. Furthermore, a new normal data base was generated. Normal 99m Tc-Sestamibi distribution was slightly different compared to 201 Tl. Using standard background subtraction, mean defect reversibility was significantly underestimated by 99m Tc-Sestamibi compared to 201 Tl (2.8 +/- 4.9 versus -1.8 +/- 8.4, p less than 0.05). Using the modified background subtraction, mean defect reversibility on 201 Tl and 99m Tc-Sestamibi images was comparable (2.8 +/- 4.9 versus 1.7 +/- 5.2, p = NS). We conclude, that for quantification of 99m Tc-Sestamibi images a new normal data base, as well as a modification of the interpolative background subtraction method should be employed to obtain quantitative results comparable to those with 201 Tl

Prospective Evaluation of (99m)Tc-sestamibi SPECT/CT for the Diagnosis of Renal Oncocytomas and Hybrid Oncocytic/Chromophobe Tumors.

Science.gov (United States)

Gorin, Michael A; Rowe, Steven P; Baras, Alexander S; Solnes, Lilja B; Ball, Mark W; Pierorazio, Phillip M; Pavlovich, Christian P; Epstein, Jonathan I; Javadi, Mehrbod S; Allaf, Mohamad E

2016-03-01

Nuclear imaging offers a potential noninvasive means of determining the histology of renal tumors. The aim of this study was to evaluate the accuracy of technetium-99m ((99m)Tc)-sestamibi single-photon emission computed tomography/x-ray computed tomography (SPECT/CT) for the differentiation of oncocytomas and hybrid oncocytic/chromophobe tumors (HOCTs) from other renal tumor histologies. In total, 50 patients with a solid clinical T1 renal mass were imaged with (99m)Tc-sestamibi SPECT/CT prior to surgical resection. Preoperative SPECT/CT scans were reviewed by two blinded readers, and their results were compared with centrally reviewed surgical pathology data. Following surgery, 6 (12%) tumors were classified as renal oncocytomas and 2 (4%) as HOCTs. With the exception of 1 (2%) angiomyolipoma, all other tumors were renal cell carcinomas (82%). (99m)Tc-sestamibi SPECT/CT correctly identified 5 of 6 (83.3%) oncocytomas and 2 of 2 (100%) HOCTs, resulting in an overall sensitivity of 87.5% (95% confidence interval [CI], 47.4-99.7%). Only two tumors were falsely positive on SPECT/CT, resulting in a specificity of 95.2% (95% CI, 83.8-99.4%). In summary, (99m)Tc-sestamibi SPECT/CT is a promising imaging test for the noninvasive diagnosis of renal oncocytomas and HOCTs. We found that the imaging test (99m)Tc-sestamibi SPECT/CT can be used to accurately diagnose two types of benign kidney tumors. This test may be eventually used to help better evaluate patients diagnosed with a renal tumor. Copyright © 2015 European Association of Urology. Published by Elsevier B.V. All rights reserved.

Tc-99m-sestamibi scintigraphy in gaucher disease, type 1

International Nuclear Information System (INIS)

Park, Chan H.; Pai, Moon S.; Ha, Man J.; Yoon, S. N.; Kim, S.; Whang, K. H.; Kim, Hyun J.

1999-01-01

Gaucher disease is an autosomal recessive disorder characterized by lysosomal glycolipid storage in reticuloendothelial cells due to the deficiency of lysosomal enzyme, acid-glucosidase. Type 1 is one of the three subtypes of Gaucher disease and is manifested by a chronic and progressive involvement of the spleen, liver, bone marrow and other visceral organs. This study was done to see imaging feasibility of bone marrow involvement of Gaucher cells using sestamibi. Five patients with Gaucher disease, type I (M:F=4:1, age range: 9-25) underwent a simultaneous anterior and posterior whole body scan as well as spot views of the lower extremities as needed in 10-20 min following the IV administration of 0.2 mCi/kg of Tc-99m-sestamibi. Control group consisted of 10 patients with osteosarcoma, simple bone cyst, nonossifying fibroma, osteoid osteoma, exostosis and neuroblastoma ( M: F=9:1, age range: 2-20, mean : 12.1) and sestamibi images of the group were obtained as in Gaucher cases. For in vitro evaluation, Gaucher cells were isolated from the splenectomy specimen. The cells were incubated in media containing sestamibi for 10, 29, 30 min. After washing the cells twice with saline, cell labeling was checked by external counting. Control group depicted no appreciable sestamibi uptake in the lower extremities while 5 patients with Gaucher disease, type I revealed variable degrees of sestamibi uptake. It was difficult to assess vertebral activities due to hepatosplenomegaly. Ioslated Gaucher cells took up sestamibi supported by an increasing external counting in proportion to incubation time. There was sestamibi uptake in the lower extremities involved by Gaucher disease, type I, which was distinctly different from the control group. Also in vitro study revealed sestamibi uptake in Gaucher cells. On the basis of these results, we believe, it may be possible to evaluate enzyme replacement therapy in Gaucher disease, type I, utilizing sestamibi scintiscan

Tc-99m-sestamibi scintigraphy in gaucher disease, type 1

Energy Technology Data Exchange (ETDEWEB)

Park, Chan H.; Pai, Moon S.; Ha, Man J.; Yoon, S. N.; Kim, S.; Whang, K. H.; Kim, Hyun J. [College of Medicine, Ajou Univ., Suwon (Korea, Republic of)

1999-07-01

Gaucher disease is an autosomal recessive disorder characterized by lysosomal glycolipid storage in reticuloendothelial cells due to the deficiency of lysosomal enzyme, acid-glucosidase. Type 1 is one of the three subtypes of Gaucher disease and is manifested by a chronic and progressive involvement of the spleen, liver, bone marrow and other visceral organs. This study was done to see imaging feasibility of bone marrow involvement of Gaucher cells using sestamibi. Five patients with Gaucher disease, type I (M:F=4:1, age range: 9-25) underwent a simultaneous anterior and posterior whole body scan as well as spot views of the lower extremities as needed in 10-20 min following the IV administration of 0.2 mCi/kg of Tc-99m-sestamibi. Control group consisted of 10 patients with osteosarcoma, simple bone cyst, nonossifying fibroma, osteoid osteoma, exostosis and neuroblastoma ( M: F=9:1, age range: 2-20, mean : 12.1) and sestamibi images of the group were obtained as in Gaucher cases. For in vitro evaluation, Gaucher cells were isolated from the splenectomy specimen. The cells were incubated in media containing sestamibi for 10, 29, 30 min. After washing the cells twice with saline, cell labeling was checked by external counting. Control group depicted no appreciable sestamibi uptake in the lower extremities while 5 patients with Gaucher disease, type I revealed variable degrees of sestamibi uptake. It was difficult to assess vertebral activities due to hepatosplenomegaly. Ioslated Gaucher cells took up sestamibi supported by an increasing external counting in proportion to incubation time. There was sestamibi uptake in the lower extremities involved by Gaucher disease, type I, which was distinctly different from the control group. Also in vitro study revealed sestamibi uptake in Gaucher cells. On the basis of these results, we believe, it may be possible to evaluate enzyme replacement therapy in Gaucher disease, type I, utilizing sestamibi scintiscan.

Quantitative assessment of regional myocardial flow reserve using Tc-99m-sestamibi imaging. Comparison with results of O-15 water PET

International Nuclear Information System (INIS)

Tsukamoto, Takahiro; Ito, Yoshinori; Noriyasu, Kazuyuki; Morita, Koichi; Katoh, Chietsugu; Okamoto, Hiroshi; Tamaki, Nagara

2005-01-01

The aims of this study were to develop a method for quantitative estimation of the myocardial blood flow index (MBFI) and myocardial flow reserve (MFR) of the whole left ventricle using 99m technetium (Tc-99m)-sestamibi imaging. Twenty-two patients with suspected coronary artery disease and 7 controls underwent both Tc-99m-sestamibi imaging and O-15 water positron emission tomography (PET). The global MBFI was calculated on the basis of the microsphere model from the ratio of the myocardial count to the area under the time-activity curve on the aortic arch. The regional MBFI was calculated from the relative distributions of Tc-99m-sestamibi uptake values. The regional MBFI and MFR (Tc-MFR) obtained using single-photon emission computed tomography were compared with the myocardial blood flow (MBF) and MFR (PET-MFR) obtained using PET as the gold standard. Regional MBFI significantly correlated with the MBF obtained using PET. Regional Tc-MFR also correlated with the regional PET-MER, with some underestimation. These results indicate that regional MBF and MFR may be estimated by dynamic Tc-99m-sestamibi imaging and can be used for the early detection and estimation of the functional severity of coronary lesions without the need for a PET camera. (author)

Diagnostic and prognostic value of {sup 99m}Tc-tetrofosmin scintigraphy in maxillofacial flaps

Energy Technology Data Exchange (ETDEWEB)

Aigner, Reingard M.; Sorantin, Erich [Department of Radiology, Division of Nuclear Medicine, Karl-Franzens University Graz, Auenbruggerplatz 9, 8036 Graz (Austria); Schultes, Guenter [Department of Oral and Maxillofacial Surgery, Karl-Franzens University Graz (Austria)

2003-02-01

In oro-maxillofacial malignancies, new therapeutic approaches are placing changing demands on the diverse diagnostic modalities. In contradistinction to mandibular reconstruction of former years, the transplants (microvascular anastomosed pedicled flaps, ''flaps'') now consist of one or more arteries feeding a soft tissue component attached to a piece of bone suitably fitted to fill the defect. We addressed the diagnostic value of technetium-99m tetrofosmin scintigraphy in differentiating between viability and non-viability of the soft tissue portion of flaps in the immediate postoperative assessment. A total of 60 patients who had received flaps for reconstruction of the mandible after partial resection were investigated with {sup 99m}Tc-tetrofosmin 3-5 days after surgery. Scintigraphy consisted of (a) radionuclide angiography, (b) static planar imaging in four projections starting at 10 min post injection, and (c) single-photon emission tomography (SPET) performed immediately after the planar imaging. Normal perfusion associated with no defects throughout the soft tissue portion of the transplant was observed in 46/60 patients. This scintigraphic pattern was identical to viability and normal postoperative follow-up. Hypoperfusion and small defects on planar and SPET images indicated viability and uncomplicated postoperative healing in 6/60 patients, but non-viability/inadequate healing of the flap in 4/60 patients. Absence of perfusion combined with a large defect on static planar and SPET images definitively showed the non-viability of the flap (4/60 patients). It is concluded that {sup 99m}Tc-tetrofosmin scintigraphy is a sensitive diagnostic tool for the immediate postoperative assessment of the viability and the adequacy of implantation of the soft tissue portion of flaps. Therefore tetrofosmin scintigraphy is an important modality in order (a) to define the optimal therapeutic regimen in the immediate postoperative period and (b) to

Changes of Tc-99m sestamibi uptake in P-glycoprotein expressing leukaemia cells treated in vivo with antisense oligodeoxynucleotide complementary to mdr1 mRNA

International Nuclear Information System (INIS)

Kinuya, S.; Yokoyama, K; Fukuoka, M.; Michigishi, T.; Tonami, N.; Shiba, K.; Mori, H.; Watanabe, N.; Shuke, N.

2006-01-01

We examined the feasibility of Tc-99m sestamibi to monitor changes of mRNA expression of MDRl/P-glycoprotein (Pgp) following antisense oligodeoxynucleotide (AS-ODN) treatment in vivo. Three days after the intraperitoneal inoculation of murine leukaemia P388/R cells expressing MDR1/P-gp in CDFI mice, 15-mer phosphorothioate ASODN to the initiation codon of mouse mdr1 mRNA was administered intraperitoneally at 10 mg/kg daily for 3 or 4 days. Cells collected from ascites were suspended in medium for Tc-99m sestamibi uptake studies. To know the duration of antisense effects, cells were harvested 2 days later after the 3-day treatment. AS-ODN treatment increased Tc-99m sestamibi uptake. Effects of 3-day treatment and 4-day treatment were the same. Treatment effects were not detected when uptake was observed 2 days after 3-day treatment. Based on the results it was concluded that in vivo treatment with AS-ODN specific to the coding portion of mdr1 mRNA increased Tc-99m sestamibi uptake in leukaemia cells possessing MDR function. (author)

The role of scintimammography with 99m-Tc-Tetrofosmin in breast cancer detection

International Nuclear Information System (INIS)

Vonorta, K.; Stefanakos, N.; Anagnostopoulos, K.; Michailidou, E.; Prassopoulos, V.; Baltas, D.; Giatas, A.; Keramopoulos, A.; Papageorgiou, S.

2002-01-01

Aim: It is already known that breast cancer is the most common malignancy of women. Breast mammography, although it is of a great importance as a screening test, it has some limitations, especially in women with dense breast tissue, or in those who underwent partial mastectomy and post-surgical scars are present. This resulted in the necessity of the use of other complementary imaging procedures, such as ultrasonography, magnetic resonance imaging and scintimammography with technetium-99m labeled agents (Methyl-Isobutyl-Isonitrile: MIBI) or monoclonal antibodies. In the present study the contribution of scintimammography with 99m- Tc- Tetrofosmin in the diagnosis of breast cancer and/or local relapses is investigated. Material-Methods: 91 women aged 22-72 years old with strong clinical and/or mammographic suspicion of breast cancer and/or local relapse after mastectomy (92 lesions) were investigated. All patients underwent scintimammography with 99m-Tc-Tetrofosmin (dose: 20mCi) before surgery and/or biopsy. An intravenous injection was performed at the contralateral site of that of the suspected or palpable lesion. Imaging was performed 10 minutes post-injection. Patients were at a prone position and lateral and views of the breasts and axillary areas were performed (10 minutes per view, matrix size 128x128, high resolution collimator).Anterior views of the breasts and axillary areas were performed with the patients placed in at supine position. Results: The overall Sensitivity was 85,7%, Specificity was 87,9%, Positive Predictive Value was 81,9%, Negative Predictive Value was 90,7% and Diagnostic Accuracy was 85,3%.Three out of three local relapses were detected,as well as one out of one bilateral involvement. In a case of negative breast scan and positive findings at the axillary area, histology revealed a lymphoma. Conclusions: Scintimammography with 99m-Tc-Tetrofosmin is a valuable method in the detection of primary breast cancer or the early diagnosis of local

Reverse redistribution phenomenon on rest 99mTc-tetrofosmin myocardial single photon emission computed tomography involves impaired left ventricular contraction in patients with acute myocardial infarction

International Nuclear Information System (INIS)

Kurokawa, Kazuyuki; Ohte, Nobuyuki; Miyabe, Hiromichi; Akita, Sachie; Yajima, Kazuhiro; Hayano, Junichiro; Kimura, Genjiro

2003-01-01

The purpose of this study was to investigate the clinical significance of the reverse redistribution (RR) phenomenon on technetium-99m ( 99m Tc)-tetrofosmin myocardial single photon emission computed tomography (SPECT) performed at rest. Twenty-five patients underwent myocardial SPECT 3 weeks after the onset of acute myocardial infarction. Myocardial images were acquired at 40 min (early) and 4 h (delayed) after the injection of 740 MBq of 99m Tc-tetrofosmin. The regional myocardial uptake of the tracer in 26 segments of the left ventricular (LV) wall was visually scored from 0 (no activity) to 3 (normal activity), and then the RR was defined as a decrease of more than 1 point in the activity score on the delayed image compared with that on the early image. Regions with an activity score of 3 on both the early and delayed images were defined as normal, and those with a score of 0 or 1 on the early image were considered to have a fixed defect. The regional myocardial 99m Tc-tetrofosmin uptake and washout rate were also quantitatively assessed in each region. In addition, exercise stress electrocardiograph-gated SPECT with 99m Tc-tetrofosmin was performed within 1 week of the rest study, and the percent count increase (%CI) during myocardial contraction in each corresponding region was studied. RR was observed in 18 of the 25 patients. The regional washout rate of 99m Tc-tetrofosmin was significantly higher in the RR regions (45.0±3.8%) than in either the normal regions (36.4±4.1%, p 99m Tc-tetrofosmin SPECT have severely impaired LV wall contraction after exercise. (author)

The role of pharmacological stress Tc-99m sestamibi myocardial perfusion imaging in an Australian population

International Nuclear Information System (INIS)

Howarth, D.M.; Booker, J.A.; Tan, T.S.K.; Bellamy, G.R.; Hardy, D.B.; Howarth, G.C.

2003-01-01

This observational study was performed in order to assess the exercise-related incremental diagnostic accuracy of Tc-99m sestamibi myocardial perfusion imaging (MPI) in a hospital-based Australian population, and to assess the relative roles of exercise and pharmacological stress in myocardial perfusion imaging (MPI). Two hundred and eight adult patients who had both Tc-99m sestamibi myocardial perfusion imaging and coronary angiography within a median time of 16 weeks were studied. The diagnostic end-point was coronary artery lesions of ≥50% and >70% stenosis detected on angiography. Using receiver operating characteristic curve analysis, the overall diagnostic accuracy was calculated, as well as the comparative accuracies in patients who undertook various levels of exercise stress testing (n=130) and those who received pharmacological (dipyridamole) stress testing (n=78). The overall respective diagnostic accuracy of Tc-99m sestamibi MPI for the diagnosis of coronary artery disease (>70% stenosis) was 81% and 76% when using the diagnostic criterion of ≥50% stenosis. On direct comparison of perfusion defects with angiographic stenoses, the respective sensitivity and specificity for the detection of >70% stenosis in each coronary artery territory was 73% and 79%. Pharmacological MPI showed a significantly greater sensitivity for the detection of localised stenoses compared to the overall group who had exercise MPI performed. Consequently, exercise stress MPI showed significantly more false negative lesions compared to dipyridamole stress imaging (p<0.003). However, a large proportion of patients were unable to perform to adequate exercise levels in this patient sample. We conclude that Tc-99m sestamibi myocardial perfusion imaging is an accurate non-invasive test for the diagnosis of coronary artery disease. Where any doubt exists as to the patient's ability to achieve exercise levels at or above 85% of the predicted value for age and gender, pharmacological

Comparison of the uptakes of Tc-99m MIBI and Tc-99m tetrofosmin in A549, an MRP-expressing cancer cell, in vitro and in vivo

International Nuclear Information System (INIS)

Yoo, Jeong Ah; Jeong, Shin Young; Seo, Myung Rang; Bae, Jin Ho; Ahn, Byeong Cheol; Lee, Kyu Bo; Lee, Jae Tae; Choi, Sang Woon; Lee, Byung Ho

2003-01-01

Uptakes of Tc-99m MIBI (MIBI) and Tc-99m tetrofosmin (tetrofosmin) in human non-small cell lung cancer A549, multidrug-resistance associated protein (MRP) expressing cell, were investigated in vitro and in vivo. Western blot analysis and immunohistochemistry were used for detetion of MRP in A549 cells with anti-MRPr1 antibody. Cellular uptakes of two tracers were evaluated at 100 μM of verapamil (Vrp), 50 μM of cyclosporin A (CsA) and 25 μM of butoxysulfoximide (BSO) after incubation with MIBI and tetrofosmin for 30 and 60 min at 37.deg.C, using single cell suspensions at 1x10 6 cells/ml. Radioactivities in supernatants and pellets were measured with gamma well counter. A549 cells were inoculated in each flanks of 24 nude mice. Group 1 (Gr1) and Gr3 mice were treated with only MIBI or tetrofosmin, and Gr2 and Gr4 mice were treated with 70mg/kg of CsA i.p. for 1 hour before injection of 370KBq of MIBI or tetrofosmin. Mice were sacrificed at 10, 60 and 240 min. Radioactivities of organs and tumors were expressed as percentage injected dose per gram of tissue (%ID/gm). Western blot analysis of the A549 cells detected expression of MRPr1 (190 kDa) and immunohistochemical staining of tumor tissue for MRPr1 revealed brownish staining in cell membrane but not P-gp. Upon incubating A549 cells for 60 min with MIBI and tetrofosmin, cellular uptake of MIBI was higher than that of tetrofosmin. Coincubation with modulators resulted in an increase in cellular uptakes of MIBI and tetrofosmin. Coincubation with modulators resulted in an increase in cellular uptakes of MIBI and tetorfosmin. Percentage increase of MIBI was higher than that of tetrofosmin with Vrp by 623% and 427%, CsA by 753% and 629% and BSO by 219% and 140%, respectively. There was no significant difference in tumoral uptakes of MIBI and tetrofosmin between Gr1 and Gr3. Percentage increases in MIBI (114% at 10 min, 257% at 60 min, 396% at 240 min) and tetrofosmin uptake (110% at 10 min, 205% at 60 min, 410% at

Measurement of absolute myocardial blood flow in humans using dynamic cardiac SPECT and^99mTc-tetrofosmin: Method and validation

OpenAIRE

Shrestha, U; Sciammarella, M; Alhassen, F; Yeghiazarians, Y; Ellin, J; Verdin, E; Boyle, A; Seo, Y; Botvinick, EH; Gullberg, GT

2017-01-01

© 2015, American Society of Nuclear Cardiology. Background: The objective of this study was to measure myocardial blood flow (MBF) in humans using 99m Tc-tetrofosmin and dynamic single-photon emission computed tomography (SPECT). Methods: Dynamic SPECT using 99m Tc-tetrofosmin and dynamic positron emission tomography (PET) was performed on a group of 16 patients. The SPECT data were reconstructed using a 4D-spatiotemporal iterative reconstruction method. The data corresponding to 9 patients w...

Technetium-99m sestamibi limb scintigraphy in post-traumatic reflex sympathetic dystrophy: preliminary results

International Nuclear Information System (INIS)

Sarikaya, A.; Firat, M.F.; Sarikaya, I.; Pekindil, G.; Pekindil, Y.

2001-01-01

Reflex sympathetic dystrophy (RSD) has widely variable clinical manifestations. Its pathogenesis remains partially unexplained. RSD is commonly divided into three stages; these stages are not always clearly separable, but staging remains important for correct treatment. Since the disease involves soft tissue alterations as well as bone changes, we decided to investigate whether technetium-99m sestamibi limb imaging can be used to evaluate the soft tissue appearance. Fifteen patients (seven females and eight males; age range 12-68 years) with clinically significant post-fracture RSD were evaluated with both three-phase bone scan (TPBS) and 99m Tc-sestamibi limb scintigraphy. Although, in general, patients with similar duration of disease, clinical stage and TPBS activity tended to have similar patterns of sestamibi uptake, discordant uptake patterns were observed in some patients with clinical stage 1. Thus, of 12 patients with stage I disease, eight had increased 99m Tc-sestamibi activity in the distal part of the affected limb, while three had normal activity and one had decreased activity. All three patients with stage II disease showed normal 99m Tc-sestamibi uptake. Although most of the patients with increased 99m Tc-sestamibi uptake had increased activity on all three phases of the bone scan, there were discordant results between the scan patterns in other patients. On the basis of these findings, we suggest that 99m Tc-sestamibi imaging may contribute to the differentiation between clinical stages and may permit evaluation of the disease course and selection of appropriate therapy. 99m Tc-sestamibi imaging is not, however, a primary diagnostic procedure for RSD. (orig.)

Measurement of absolute myocardial blood flow in humans using dynamic cardiac SPECT and 99mTc-tetrofosmin: Method and validation.

Science.gov (United States)

Shrestha, Uttam; Sciammarella, Maria; Alhassen, Fares; Yeghiazarians, Yerem; Ellin, Justin; Verdin, Emily; Boyle, Andrew; Seo, Youngho; Botvinick, Elias H; Gullberg, Grant T

2017-02-01

The objective of this study was to measure myocardial blood flow (MBF) in humans using 99m Tc-tetrofosmin and dynamic single-photon emission computed tomography (SPECT). Dynamic SPECT using 99m Tc-tetrofosmin and dynamic positron emission tomography (PET) was performed on a group of 16 patients. The SPECT data were reconstructed using a 4D-spatiotemporal iterative reconstruction method. The data corresponding to 9 patients were used to determine the flow-extraction curve for 99m Tc-tefrofosmin while data from the remaining 7 patients were used for method validation. The nonlinear tracer correction parameters A and B for 99m Tc-tefrofosmin were estimated for the 9 patients by fitting the flow-extraction curve [Formula: see text] for K 1 values estimated with 99m Tc-tefrofosmin using SPECT and MBF values estimated with 13 N-NH 3 using PET. These parameters were then used to calculate MBF and coronary flow reserve (CFR) in three coronary territories (LAD, RCA, and LCX) using SPECT for an independent cohort of 7 patients. The results were then compared with that estimated with 13 N-NH 3 PET. The flow-dependent permeability surface-area product (PS) for 99m Tc-tefrofosmin was also estimated. The estimated flow-extraction parameters for 99m Tc-tefrofosmin were found to be A = 0.91 ± 0.11, B = 0.34 ± 0.20 (R 2  = 0.49). The range of MBF in LAD, RCA, and LCX was 0.44-3.81 mL/min/g. The MBF between PET and SPECT in the group of independent cohort of 7 patients showed statistically significant correlation, r = 0.71 (P < .001). However, the corresponding CFR correlation was moderate r = 0.39 yet statistically significant (P = .037). The PS for 99m Tc-tefrofosmin was (0.019 ± 0.10)*MBF + (0.32 ± 0.16). Dynamic cardiac SPECT using 99m Tc-tetrofosmin and a clinical two-headed SPECT/CT scanner can be a useful tool for estimation of MBF.

Development of Tc99m-Saccharic Acid for Heart Imaging

International Nuclear Information System (INIS)

Shafii Khamis; Mohd Azfar Adenan; Bohari Yaacob; Amir Fitri Shafii

2014-01-01

Cardiovascular disease especially the coronary heart disease (CHD) is the leading cause of death worldwide. Coronary heart disease is a common term for the buildup of plaque in the heart coronary arteries that could block the blood supply to the myocardial and this could lead to heart attack. An estimated 17 million people died from cardiovascular disease in 2008 representing 30% of all global death. In United Kingdom, coronary heart disease killed as much as 82,000 people each year. Hence, early detection of the coronary heart disease is very important in reducing the mortality among the world population. One of the most sensitive detection methods is by radioimaging using Technetium-99m radiopharmaceuticals. Several different radio imaging agents such as Tc99m radiopharmaceutical were developed as radiagnostic agent in determining the CHD especially in identifying the blockage of the coronary artery of the heart muscle. Despite the success of Tc99m-sestamibi and Tc99m-tetrofosmin as effective agents for myocardial perfusion study, the search for other Tc99m heart imaging agents has never been interrupted. This report described the formulation of the Tc99m-saccharic acid radiopharmaceutical kit, radiolabelling of the kit, radiochemical purity evaluation of the Tc99m labeled saccharaic acid, and animal study involving radio imaging using gamma camera. The animal are then sacrificed and the biological distribution of the Tc99m-saccharic acid in-vivo was determined. Comparative study was also conducted using commercially available Tc99m-tetrafosmin, a CHD radiopharmaceutical kit. The Tc99m-saccharic acid developed gave a very high labeling efficiency of >92% with Tc99m and good uptake in the heart muscle. The saccharic acid kit developed was also found to be comparable in quality to the commercially available Tc99-tetrafosmin kit. (author)

Assessment of myocardial washout of Tc-99m-sestamibi in patients with chronic heart failure. Comparison with normal control

Energy Technology Data Exchange (ETDEWEB)

Kumita, Shin-ichiro; Seino, Yoshihiko; Cho, Keiichi; Nakajo, Hidenobu; Toba, Masahiro; Fukushima, Yoshimitsu; Takano, Teruo; Kumazaki, Tatsuo [Nippon Medical School, Tokyo (Japan); Okamoto, Noriake [Bristol-Myers Squibb K.K., Tokyo (Japan)

2002-06-01

In contrast to {sup 201}TlCl, {sup 99m}Tc-sestamibi shows very slow myocardial clearance after its initial myocardial uptake. In the present study, myocardial washout of {sup 99m}Tc-sestamibi was calculated in patients with non-ischemic chronic heart failure (CHF) and compared with biventricular parameters obtained from first-pass and ECG-gated myocardial perfusion SPECT data. After administration of {sup 99m}Tc-sestamibi, 25 patients with CHF and 8 normal controls (NC) were examined by ECG-gated myocardial perfusion SPECT and planar data acquisition in the early and delayed (interval of 3 hours) phase. Left ventricular ejection fraction (LVEF, %), peak filling rate (PFR, sec{sup -1}), end-diastolic volume (LVEDV, ml) and end-systolic volume (LVESV, ml) were automatically calculated from the ECG-gated SPECT data. Myocardial washout rates over 3 hours were calculated from the early and delayed planar images. Myocardial washout rates in the CHF group (39.6{+-}5.2%) were significantly higher than those in the NC group (31.2{+-}5.5%, p<0.01). The myocardial washout rates for the 33 subjects showed significant correlations with LVEF (r=-0.61, p<0.001), PFR (r=-0.47, p<0.01), LVEDV (r=0.45, p<0.01) and LVESV (r=0.48, p<0.01). The myocardial washout rate of {sup 99m}Tc-sestamibi is considered to be a novel marker for the diagnosis of myocardial damage in patients with chronic heart failure. (author)

Quantitative comparison of technetium-99m tetrofosmin and thallium-201 images of the thyroid and abnormal parathyroid glands

International Nuclear Information System (INIS)

Giordano, A.; Meduri, G.; Calcagni, M.L.; Marozzi, P.; Ficola, U.; Vaccaro, A.; Rubini, G.; Attard, M.; Li Puma, M.; Ricci, R.; Corsello, S.

1999-01-01

The aim of the study was to quantitatively compare the scintigraphic images of the thyroid and abnormal parathyroid glands obtained with technetium-99m tetrofosmin and thallium-201 in patients with hyperparathyroidism. Forty-six patients with hyperparathyroidism underwent 201 Tl (74 MBq), 99m Tc-pertechnetate (74 MBq) and 99m Tc-tetrofosmin (555-740 MBq) scintigraphy in a single session. Image analysis included the computation of the thyroid/background ratio in the whole study population and the parathyroid/background ratio, parathyroid/thyroid ratio and diagnostic sensitivity in 17 patients who underwent parathyroid surgery. The pertechnetate subtraction technique was used. 201 Tl and 99m Tc-tetrofosmin showed a similar thyroid/background ratio (1.79±0.41 and 1.81±0.47, respectively, P=NS); however, 99m Tc-tetrofosmin showed a higher parathyroid/background ratio than 201 Tl (2.06±0.54 vs 1.79± 0.50, P=0.007). Despite the superior quality of 99m Tc-tetrofosmin images, both tracers showed identical sensitivity in detecting enlarged parathyroid glands in patients with primary hyperparathyroidism (89%) and in those with secondary hyperparathyroidism (50%). (orig.)

Radiation exposure near of patients after administration of 99mTc-Sestamibi

International Nuclear Information System (INIS)

Kurtaran, A.; Preitfellner, J.; Virgolini, I.; Schaffarich, P.; Scheuba, C.; Niederle, B.; Havlik, E.

1997-01-01

Aim: The aim of the present study was to estimate the additional radiation exposure to personnel, other patients and members of the family caused by patients who had been injected with 99m Tc-Sestamibi (Cardiolite R DuPONT PHARMA) for preoperative localization of parathyroid adenoma. Methods: Dose rates were measured from 16 patients who had received an intravenous injection of 600±50 MBq 99m Tc-Sestamibi. All measurements were performed with a portable dosimeter (Berthold LB 133 R ) at 3 different distances (0.5, 1 and 2 m) at 10 min, 180-200 min and 24 h after administration of the tracer. Results: The dose rates amounted to 20.5 μSv/h at 0.5 m, 5.25 μSv/h at 1 m and 1.55 μSv/h at 2 m distance from patients respectively. The biological half-life was 54 h. The calculated maximal dose to other persons in the waiting area was 31.2 μSv, to family members 27.6 μSv and to nurses in a ward 31.2 μSv. Conclusion: Our results indicate that the calculated maximal radiation exposure for personnel, family members and other patients even under very unfavourable conditions was below the maximal allowed dose for non-professionally exposed persons. (orig.) [de

Estimation of myocardial blood flow and myocardial flow reserve by 99mTc-sestamibi imaging: comparison with the results of [15O]H2O PET

International Nuclear Information System (INIS)

Ito, Yoshinori; Noriyasu, Kazuyuki; Kohya, Tetsuro; Kitabatake, Akira; Katoh, Chietsugu; Kuge, Yuji; Furuyama, Hideto; Morita, Koichi; Tamaki, Nagara

2003-01-01

We developed a noninvasive method to quantitatively estimate the myocardial blood flow (MBF) index and flow reserve (MFR) using dynamic and static data obtained with technetium-99m sestamibi, and compared the results with MBF and MFR measured by oxygen-15-labeled water ([ 15 O]H 2 O) PET. Twenty patients with coronary artery disease (CAD) and nine normal subjects underwent both 99m Tc-sestamibi and PET studies within 2 weeks. From the anterior view, dynamic data were acquired for 2 min immediately after the injection of 99m Tc-sestamibi, and planar static images were also obtained after 5 min at rest and during ATP stress (0.16 mg kg -1 min -1 for 5 min) on another day. The area under the time-activity curve on the aortic arch (Aorta ACU), myocardial weight with the SPET image (M), and the myocardial count on the planar image for 1 min (C m ) were obtained. The MBF index (MBFI) was calculated as follows: MBFI=C m /Aorta ACU x 100/M. MFR was measured by dividing the MBFI at ATP stress by MBFI at rest. The MBFI measured by 99m Tc-sestamibi was significantly correlated with MBF obtained using [ 15 O]H 2 O PET (MBFI=13.174+11.732 x MBF, r=0.821, P 99m Tc-sestamibi was well correlated with that obtained using [ 15 O]H 2 O PET, with some underestimation (r=0.845, P 99m Tc-sestamibi in patients with CAD was significantly lower than that in normal subjects (CAD: 1.484±0.256 vs normal: 2.127±0.308, P 99m Tc-sestamibi. This may be useful for the quantitative assessment of CAD, especially in those patients with diffuse coronary disease. (orig.)

11C-methionine PET/CT in 99mTc-sestamibi-negative hyperparathyroidism in patients with renal failure on chronic haemodialysis

International Nuclear Information System (INIS)

Rubello, Domenico; Fanti, Stefano; Nanni, Cristina; Farsad, Mohsen; Castellucci, Paolo; Boschi, Stefano; Franchi, Roberto; Mariani, Giuliano; Fig, Lorraine M.; Gross, Milton D.

2006-01-01

Scintigraphic localisation of parathyroid glands is often unsuccessful in patients with renal failure on chronic haemodialysis who have secondary hyperparathyroidism (HPT). The purpose of this study was to investigate the use of 11 C-methionine PET/CT to detect hyperfunctioning parathyroid glands in patients with renal failure on chronic haemodialysis who had 99m Tc-sestamibi-negative HPT. 11 C-methionine PET/CT was performed in 18 patients (11 women and 7 men, aged 42-79 years; mean age 57.8 years) on haemodialysis for renal failure (2-14 years' duration), with normo-, hypo- or hypercalcaemia and HPT not localised by either dual-tracer 99m Tc-pertechnetate/ 99m Tc-sestamibi subtraction scans or dual-phase 99m Tc-sestamibi scans. In three of ten patients with normo- or hypocalcaemic HPT there was increased 11 C-methionine accumulation in one gland. Seven of eight patients with hypercalcaemic HPT showed increased uptake: in five of these patients increased 11 C-methionine accumulation was present in one gland, while in two it was demonstrated in two glands. All patients also had high-resolution ultrasound of the neck and were treated with subtotal parathyroidectomy, leaving a remnant of the smallest of the four glands. Regardless of their size, all glands with abnormal 11 C-methionine parathyroid uptake were removed, and all demonstrated parathyroid hyperplasia. All patients developed post-parathyroidectomy hypoparathyroidism and one patient with normocalcaemic HPT relapsed 8 months after surgery. These data suggest that 11 C-methionine PET/CT may be used to identify hyperfunctioning parathyroid glands in non-primary HPT, and especially hypercalcaemic HPT, when conventional 99m Tc-sestamibi imaging is non-localising. (orig.)

New chromatographic systems for the quality control determination of 99Tcm-tetrofosmin

International Nuclear Information System (INIS)

Penglis, S.; Tsopelas, C.

1999-01-01

Full text: The manufacturer's method for assessing the radiochemical purity (RCP) of 99 Tc m -tetrofosmin requires the use of a volatile solvent system on silica gel impregnated thin layer chromatography strips, and is a time-consuming procedure (> 15 minutes). A rapid quality control procedure for this product has already been proposed which utilizes miniature Whatman 1 paper strips with ethyl acetate as the mobile phase, where 99 Tc m -tetrofosmin appears at the solvent front (R f 0.9). In our laboratory, this procedure was found to be unreliable, prompting us to develop two new and improved methods to successfully determine the % RCP of 99 Tc m -tetrofosmin. These include: (1) an Amprep anion exchange cartridge with absolute ethanol as the mobile phase; and (2) a miniature Whatman 17 strip with ethyl acetate:acetone [1:9] as the mobile phase. 99 Tc m -tetrofosmin elutes with the solvent, and 99 Tc m O 2 plus 99 Tc m O 4 -remain on the cartridge for the cartridge method. 99 Tc m -tetrofosmin moves with the solvent front (Rf 0.8) and the other 99 Tc m -impurities remain at the origin for the Whatman paper method. The % RCP of 99 Tc m -tetrofosmin (n = 8) by the manufacturer's method was 96.5 ± 1.5%, as compared to the cartridge method (98.0 ± 0.9%) and Whatman paper method (97.3 ± 0.9%) at 0-2 h post-reconstitution. The quality control determinations gave a result in 3 or 5 min for the cartridge or Whatman paper methods respectively. These methods can be used successfully in a dose calibrator for counting, particularly if the total counts are > 1.5 MBq. These new methods were found to be highly reproducible, convenient and rapid for the routine analysis of 99 Tc m -tetrofosmin preparations

In vivo detection of multidrug-resistant (MDR1) phenotype by technetium-99m sestamibi scan in untreated breast cancer patients

International Nuclear Information System (INIS)

Del Vecchio, S.; Ciarmiello, A.; Potena, M.I.; Carriero, M.V.; Mainolfi, C.; Botti, G.; Thomas, R.; Cerra, M.; D'Aiuto, G.; Tsuruo, T.; Salvatore, M.

1997-01-01

Technetium-99m sestamibi is a transport substrate recognised by the multidrug-resistant P-glycoprotein (Pgp). To test whether 99m Tc-sestamibi efflux is enhanced in breast carcinomas overexpressing Pgp, we determined the efflux rates of 99m Tc-sestamibi and Pgp levels in tumours from 30 patients with untreated breast carcinoma. Patients were intravenously injected with 740 MBq of 99m Tc-sestamibi and underwent a 15-min dynamic study followed by the acquisition of static planar images at 0.5, 1, 2 and 4 h. Tumour specimens were obtained from each patient 24 h after 99m Tc-sestamibi scan and Pgp levels were determined using 125 I-MRK16 monoclonal antibody and in vitro quantitative autoradiography. All breast carcinomas showed high uptake of 99m Tc-sestamibi and data from region of interest analysis on sequential images were fitted with a monoexponential function. The efflux rates of 99m Tc-sestamibi, calculated from decay-corrected time-activity curves, ranged between 0.00121 and 0.01690 min -1 and were directly correlated with Pgp levels measured in the same tumours (r=0.62; P 99m Tc-sestamibi efflux from tumours of group A was 2.7 times higher than that observed in tumours of group B (0.00686 ±0.00390 min -1 vs 0.00250 ±0.00090 min -1 , P 99m Tc-sestamibi showed a sensitivity and a specificity of 80% and 95%, respectively. In conclusion, the efflux rate of 99m Tc-sestamibi may be used for the in vivo identification of the multidrug resistant (MDR1) phenotype in untreated breast cancer patients. (orig.). With 7 figs., 3 tabs

Scintigraphic study of palpable breast nodes with {sup 99m} Tc-tetrofosmin; Estudo cintilografico de nodulos palpaveis da mama com {sup 99m} Tc - tetrofosmin

Energy Technology Data Exchange (ETDEWEB)

Pellini, Marcos Pinto; Fonseca, Lea Mirian Barbosa da [Universidade Federal, Rio de Janeiro, RJ (Brazil). Faculdade de Medicina. Dept. de Radiologia; Amarante Junior, Jose Luiz de Medeiros [Hospital Naval Marcilio Dias, Rio de Janeiro, RJ (Brazil). Servico de Medicina Nuclear; Fabricio, Maria Ines Menescal [Universidade Federal, Rio de Janeiro, RJ (Brazil). Inst. de Ginecologia

1998-12-01

In Brazil, breast carcinoma has the greater incidence among women. In 1996, about 31,210 new cases were diagnosed. The purpose of this study is to determine if {sup 99m} technetium-tetrofosmin preferentially concentrates within malignant palpable breast nodes, distinguishing them from the benign lumps. Fifth-four consecutive and unsolicited women, mean age 47.5 +- 10.7 years, with palpable nodes in breast, underwent breast scintigraphy with {sup 99m} technetium-tetrofosmin and excisional biopsy or fine needle puncture within interval eight weeks. Histopathologic studies demonstrated 13 cysts, 1 cyst with local inflammation, 11 fibroadenoma, 2 fibrodysplasias, 3 fibroadenomas with high cellularity, 1 fibrocystic change with local inflammation, 23 invasive intraductal carcinomas and 1 invasive lobular carcinoma. The nodes ranged from 10 to 100 mm in greater diameter. The scintigraphic study yielded 30 true-negative cases, 24 true-positives, no false-negative and 1 false-positive. This case was a fibrocystic lump with local inflammation. Two patients had metastases in axillary lymph nodes, well detected in scintigraphy. The statistic analysis showed: sensitivity, 100%; specificity, 96.8%; accuracy, 98.2%; negative predictive value, 100%; positive predictive value, 96.0%. Nonparametric tests of Fisher and Chi-square rejected the antithesis at a confidence interval of 99.9% (p < 0.001). We concluded that {sup 99m} technetium-tetrofosmin preferentially concentrates in malignant palpable breast nodes and can help to distinguish them from the benign tumors with with very high accuracy. (author)

Technetium-99m sestamibi imaging in paediatric neuroblastoma and ganglioneuroma and its relation to P-glycoprotein

International Nuclear Information System (INIS)

Moerloose, B. de; Dhooge, C.; Benoit, Y.; Laureys, G.; Wiele, C. van de; Dierckx, R.A.; Philippe, J.; Speleman, F.

1999-01-01

Imaging with technetium-99m sestamibi offers a non-invasive approach to detect the presence of functional P-glycoprotein (Pgp), one of the major causes of multidrug resistance, in human malignancies. A clinical role for Pgp has been suggested in the subpopulation of primary neuroblastoma without amplification of the proto-oncogene MYCN. We wanted to evaluate the usefulness of 99m Tc-sestamibi scintigraphy in the screening of neural crest tumours for the presence of Pgp. In ten children suffering from MYCN-negative neuroblastoma, ganglioneuroblastoma or ganglioneuroma, 99m Tc-sestamibi imaging was performed at initial diagnosis. All patients underwent planar imaging 20-30 min and 3.5-4 h after intravenous injection of 740 MBq/1.73 m 2 99m Tc-sestamibi. Tumour to normal tissue ratios, as well as washout rates, were determined and compared with in vitro flow cytometric analysis of Pgp expression and function. Pgp expression was analysed flow cytometrically with the monoclonal antibodies 4E3 and MRK16, and Pgp function was evaluated by means of rhodamine 123 uptake and efflux either in the absence or in the presence of the Pgp inhibitor verapamil. In nine of ten patients, we found that the intratumoral 99m Tc-sestamibi activity was comparable to the background activity, which might be suggestive of Pgp presence. This was confirmed flow cytometrically in all but one patient. 99m Tc-sestamibi enhancement was seen in the primary tumour and the bone marrow metastases of one of the ten patients, and this result was concordant with a negative Pgp status. The findings presented suggest that 99m Tc-sestamibi imaging results might correlate with the presence of functional Pgp in neural crest tumours without MYCN amplification. (orig.)

Technetium-99m sestamibi imaging in paediatric neuroblastoma and ganglioneuroma and its relation to P-glycoprotein

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Moerloose, B. de; Dhooge, C.; Benoit, Y.; Laureys, G. [Department of Pediatrics, University Hospital Gent (Belgium); Wiele, C. van de; Dierckx, R.A. [Department of Nuclear Medicine, University Hospital Gent (Belgium); Philippe, J. [Department of Clinical Chemistry, Microbiology and Immunology, University Hospital Gent (Belgium); Speleman, F. [Department of Medical Genetics, University Hospital Gent (Belgium)

1999-04-29

Imaging with technetium-99m sestamibi offers a non-invasive approach to detect the presence of functional P-glycoprotein (Pgp), one of the major causes of multidrug resistance, in human malignancies. A clinical role for Pgp has been suggested in the subpopulation of primary neuroblastoma without amplification of the proto-oncogene MYCN. We wanted to evaluate the usefulness of {sup 99m}Tc-sestamibi scintigraphy in the screening of neural crest tumours for the presence of Pgp. In ten children suffering from MYCN-negative neuroblastoma, ganglioneuroblastoma or ganglioneuroma, {sup 99m}Tc-sestamibi imaging was performed at initial diagnosis. All patients underwent planar imaging 20-30 min and 3.5-4 h after intravenous injection of 740 MBq/1.73 m{sup 2} {sup 99m}Tc-sestamibi. Tumour to normal tissue ratios, as well as washout rates, were determined and compared with in vitro flow cytometric analysis of Pgp expression and function. Pgp expression was analysed flow cytometrically with the monoclonal antibodies 4E3 and MRK16, and Pgp function was evaluated by means of rhodamine 123 uptake and efflux either in the absence or in the presence of the Pgp inhibitor verapamil. In nine of ten patients, we found that the intratumoral {sup 99m}Tc-sestamibi activity was comparable to the background activity, which might be suggestive of Pgp presence. This was confirmed flow cytometrically in all but one patient. {sup 99m}Tc-sestamibi enhancement was seen in the primary tumour and the bone marrow metastases of one of the ten patients, and this result was concordant with a negative Pgp status. The findings presented suggest that {sup 99m}Tc-sestamibi imaging results might correlate with the presence of functional Pgp in neural crest tumours without MYCN amplification. (orig.) With 4 figs., 2 tabs., 44 refs.

99mTc-sestamibi muscle scintigraphy to assess the response to neuromuscular electrical stimulation of normal quadriceps femoris muscle

International Nuclear Information System (INIS)

Pekindil, Y.; Sarikaya, A.; Birtane, M.; Pekindil, G.; Salan, A.

2001-01-01

Neuromuscular electrical stimulation (NMES) is widely used for improving muscle strength by simultaneous contraction in the prevention of muscle atrophy. Although there exist many clinical methods for evaluating the therapeutic response of muscles, 99m Tc-sestamibi which is a skeletal muscle perfusion and metabolism agent has not previously been used for this purpose. The aim of our work was to ascertain whether 99m Tc-sestamibi muscle scintigraphy is useful in the monitoring of therapeutic response to NMES in healthy women. The study included 16 women aged between 21 and 45, with a mean age of 32.7±6.4. Both quadriceps femoris muscles (QFM) of each patient were studied. After randomization to remove the effect of the dominant side, one QFM of each patient was subjected to the NMES procedure for a period of 20 days. NMES was performed with an alternating biphasic rectangular current, from a computed electrical stimulator daily for 23 minutes. After measurement of skinfold thickness over the thigh, pre- and post-NMES girth measurements were assessed in centimeters. Sixty minutes after injections of 555 MBq 99m Tc-sestamibi, static images of the thigh were obtained for 5 minutes. The thigh-to-knee uptake ratio was calculated by semiquantitative analysis and normalized to body surface area (NUR=normalized uptake ratio). The difference between the pre and post NMES NUR values was significant (1.76±0.31 versus 2.25±0.38, p=0.0000). The percentage (%) increase in NUR values also well correlated with the % increase in thigh girth measurements (r=0.89, p=0.0000). These results indicated that 99m Tc-sestamibi muscle scintigraphy as a new tool may be useful in evaluating therapeutic response to NMES. (author)

Preoperative nodal staging of non-small cell lung cancer using 99mTc-sestamibi spect/ct imaging

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Juliana Muniz Miziara

2011-01-01

Full Text Available OBJECTIVES: The proper nodal staging of non-small cell lung cancer is important for choosing the best treatment modality. Although computed tomography remains the first-line imaging test for the primary staging of lung cancer, its limitations for mediastinum nodal staging are well known. The aim of this study is to evaluate the accuracy of hybrid single-photon emission computed tomography and computed tomography using 99mTc-sestamibi in the nodal staging of patients with non-small cell lung cancer and to identify potential candidates for surgical treatment. METHODS: Prospective data were collected for 41 patients from December 2006 to February 2009. The patients underwent chest computed tomography and single-photon emission computed tomography/computed tomography examinations with 99mTc-sestamibi within a 30-day time period before surgery. Single-photon emission computed tomography/computed tomography was considered positive when there was focal uptake of sestamibi in the mediastinum, and computed tomography scan when there was lymph nodes larger than 10 mm in short axis. The results of single-photon emission computed tomography and computed tomography were correlated with pathology findings after surgery. RESULTS: Single-photon emission computed tomography/computed tomography correctly identified six out of 19 cases involving hilar lymph nodes and one out of seven cases involving nodal metastases in the mediastinum. The sensitivity, specificity, positive predictive value, and negative predictive value for 99mTc-sestamibi single-photon emission computed tomography/computed tomography in the hilum assessment were 31.6%, 95.5%, 85.7%, and 61.8%, respectively. The same values for the mediastinum were 14.3%, 97.1%, 50%, and 84.6%, respectively. For the hilar and mediastinal lymph nodes, chest tomography showed sensitivity values of 47.4% and 57.1%, specificity values of 95.5% and 91.2%, positive predictive values of 90% and 57.1% and negative

Preoperative nodal staging of non-small cell lung cancer using 99mTc-sestamibi SPECT/CT imaging

International Nuclear Information System (INIS)

Miziara, Juliana Muniz; Rocha, Euclides Timoteo da; Miziara, Jose Elias Abrao; Garcia, Gustavo Fabene; Simoes, Maria Izilda Previato; Lopes, Marco Antonio; Kerr, Ligia Maria; Buchpiguel, Carlos Alberto

2011-01-01

Objectives: The proper nodal staging of non-small cell lung cancer is important for choosing the best treatment modality. Although computed tomography remains the first-line imaging test for the primary staging of lung cancer, its limitations for mediastinum nodal staging are well known. The aim of this study is to evaluate the accuracy of hybrid single-photon emission computed tomography and computed tomography using 99m Tc-sestamibi in the nodal staging of patients with non-small cell lung cancer and to identify potential candidates for surgical treatment. Methods: Prospective data were collected for 41 patients from December 2006 to February 2009. The patients underwent chest computed tomography and single-photon emission computed tomography/computed tomography examinations with 99m Tc-sestamibi within a 30-day time period before surgery. Single-photon emission computed tomography/computed tomography was considered positive when there was focal uptake of sestamibi in the mediastinum, and computed tomography scan when there was lymph nodes larger than 10 mm in short axis. The results of single-photon emission computed tomography and computed tomography were correlated with pathology findings after surgery. Results: Single-photon emission computed tomography/computed tomography correctly identified six out of 19 cases involving hilar lymph nodes and one out of seven cases involving nodal metastases in the mediastinum. The sensitivity, specificity, positive predictive value, and negative predictive value for 99m Tc-sestamibi single-photon emission computed tomography/computed tomography in the hilum assessment were 31.6%, 95.5%, 85.7%, and 61.8%, respectively. The same values for the mediastinum were 14.3%, 97.1%, 50%, and 84.6%, respectively. For the hilar and mediastinal lymph nodes, chest tomography showed sensitivity values of 47.4% and 57.1%, specificity values of 95.5% and 91.2%, positive predictive values of 90% and 57.1% and negative predictive values of 67

Double-phase Tc-99m tetrofosmin parathyroid scan in hyperparathyroidism: comparison with ultrasonography

International Nuclear Information System (INIS)

Kim, In Soo; Kim, Sang Yoon; Zeon, Seok Kil; Won, Kyoung Sook

2004-01-01

This study was performed to evaluate the utility of double-phase Tc-99m Tetrofosmin(TF) parathyroid scan in the detection of pathologic lesions of primary hyperparathyroidism, and comparison with the ultrasonography(US). The double phase TF parathyroid scan of the anterior neck including upper mediastinum with 800 MBq TF were acquired at ten minutes (early phase) and at two hours (delayed phase) after radiopharmaceutical injection, in 24 consecutive patients under the clinical impression of primary hyperparathyroidism and hypercalcaemia. The images were evaluated for abnormal focal areas of increased tracer localization in the anterior neck and superior mediastinum in early phase, and visualization of parathyroid gland radioactivity after wash-out of the thyroid gland radioactivity in delayed phase. US of the anterior neck including upper mediastinum was performed by a diagnostic radiologist in 24 consecutive patients, within one week before or after the scan. The findings of double phase TF parathyroid scan and US were compared with the pathologic results. Ten of 24 patients were surgically explored and pathologic results showed eight adenomas and two hyperplasia. The double phase TF parathyroid scan showed positive findings in seven patients of eight adenomas and one patient of two hyperplasia patients. US image showed positive findings in six patients of eight adenomas and no positive findings of two hyperplasia. The sensitivity of the double phase TF scan for detection of the causes of the primary hyperparathyroidism was 80% and US was 60%. The double phase Tc-99m Tetrofosmin parathyroid scan showed higher sensitivity in detection of the pathologic lesions of primary hyperparathyroidism than ultrasonography

{sup 99m}Tc sestamibi cardiac tomography and dobutamine echocardiography in the identification of reversible left ventricular dysfunction in patients with acute myocardial infarction; Tomografia cardiaca con {sup 99m}Tc sestamibi ed ecocardiografia con dobutamina nell'identificazione della disfunzione ventricolare sinistra reversibile nei pazienti con infarto acuto del miocardio

Energy Technology Data Exchange (ETDEWEB)

Gisonni, P.; Cuocolo, A.; Spinelli, L.; Acampa, W.; Florimonte, L.; Nicolai, E.; Petretta, M.; Sodano, A. [Naples Univ. Federico 2. (Italy). Centro per la Medicina Nucleare del Consiglio Nazionale delle Ricerche. Dipt. di Scienze Biomorfologiche e Funzionali

1999-04-01

The authors investigated the role of technetium-99m ({sup 99m}Tc) sestamibi cardiac imaging and dobutamine echocardiography in detecting myocardial viability early after acute myocardial infarction. [Italian] La presenza di tessuto miocardico ibernato o stordito contribuisce alla genesi della disfunzione ventricolare sinistra nei pazienti con infarto del miocardio. L'identificazione del miocardio malfunzionante ma ancora vitale ha particolare rilevanza nel predire il recupero della funzione ventricolare in seguito a interventi di rivascolarizzazione coronarica. In questo studio e' stato valutato il ruolo della scintigrafia con tecnezio-99m ({sup 99m}Tc) sestamibi e dell'ecocardiografia con dobutamina nell'identificazione del miocardio vitale dopo infarto acuto del miocardio.

Adsorption of technetium-99m tetrofosmin and technetium-99m furifosmin on plastic syringes

International Nuclear Information System (INIS)

Bartosch, R.; Granegger, S.; Sinzinger, H.

1998-01-01

Some groups have reported that adsorption of radiopharmaceuticals on disposable plastic syringes can reach levels of almost 50%. This high loss of radioactivity stimulated us to carry out similar studies. Our measurements were done in combination with patient studies. Therefore, we used 2-ml syringes, all of the same brand. The radioactivity in the syringe was measured immediately before and after injection. a total of 500-600 MBq technetium-99m labelled tetrofosmin or technetium-99m furifosmin was administered to 48 patients using four different injection techniques (n = 6 for each technique with each tracer): with needles, 1 min blood incubation at 22 C, 10 or 30 min after preparation of the tracer; with butterflies, 1 min blood incubation at 22 C, 10 or 30 min after preparation of the tracer. Neither in syringes nor in needles or butterflies did more than 7% of the initial radioactivity remain. The entire residual activity in syringe plus needle or syringe plus butterfly together never exceeded the 9% limit. Furthermore, in a pilot study we measured the remaining radioactivity in the vial; here, too, we found no more than 14% of total radioactivity. These findings indicate that total retention of radioactivity during elution and application of 99m Tc-tetrofosmin and 99m Tc-furifosmin with material used in our setting does not approach relevant amounts. (orig.)

{sup 99m}Tc-sestamibi muscle scintigraphy to assess the response to neuromuscular electrical stimulation of normal quadriceps femoris muscle

Energy Technology Data Exchange (ETDEWEB)

Pekindil, Y.; Sarikaya, A.; Birtane, M.; Pekindil, G.; Salan, A. [Trakya Univ., Edirne (Turkey). Hospital

2001-08-01

Neuromuscular electrical stimulation (NMES) is widely used for improving muscle strength by simultaneous contraction in the prevention of muscle atrophy. Although there exist many clinical methods for evaluating the therapeutic response of muscles, {sup 99m}Tc-sestamibi which is a skeletal muscle perfusion and metabolism agent has not previously been used for this purpose. The aim of our work was to ascertain whether {sup 99m}Tc-sestamibi muscle scintigraphy is useful in the monitoring of therapeutic response to NMES in healthy women. The study included 16 women aged between 21 and 45, with a mean age of 32.7{+-}6.4. Both quadriceps femoris muscles (QFM) of each patient were studied. After randomization to remove the effect of the dominant side, one QFM of each patient was subjected to the NMES procedure for a period of 20 days. NMES was performed with an alternating biphasic rectangular current, from a computed electrical stimulator daily for 23 minutes. After measurement of skinfold thickness over the thigh, pre- and post-NMES girth measurements were assessed in centimeters. Sixty minutes after injections of 555 MBq {sup 99m}Tc-sestamibi, static images of the thigh were obtained for 5 minutes. The thigh-to-knee uptake ratio was calculated by semiquantitative analysis and normalized to body surface area (NUR=normalized uptake ratio). The difference between the pre and post NMES NUR values was significant (1.76{+-}0.31 versus 2.25{+-}0.38, p=0.0000). The percentage (%) increase in NUR values also well correlated with the % increase in thigh girth measurements (r=0.89, p=0.0000). These results indicated that {sup 99m}Tc-sestamibi muscle scintigraphy as a new tool may be useful in evaluating therapeutic response to NMES. (author)

Technetium-99m Sestamibi in Multiple Myeloma

International Nuclear Information System (INIS)

Saber, R.A.

2002-01-01

Technetium-99m 2-methoxy - isobutyl - isonitrile (99mTc-MIBI) has been reported to be useful in evaluating patients with multiple myeloma. The aim of this study is to evaluate the role of technetium-99m sestamibi (99mTc-MIBI) scintigraphy in the diagnosis. staging and follow-up of patients with multiple myeloma. Methods and Materials: twenty-five consecutive patients with multiple myeloma were studied using 99mTc- MIBI. Of the 25 patients included in this study, 6 were in stage I, II in stage II and 8 in stage III. Anterior and posterior whole-body imaging were obtained 20 min after I.V. injection of 740 MBq of 99mTc-MIBI. Four different MIBI patterns could be described in our patients: physiological (P), diffuse (D), focal (F) and combined diffuse and focal (D+F). All patients in stages II and III as well as 3 patients in stage I were treated with chemotherapy (cyclophosphamide and prednisone) then 99mTc-MlBI scans were repeated after 6 courses. Results: in comparison to conventional X-ray skeletal survey, 99mTc-MIBI scans showed a higher number of myeloma bone disease at diagnosis. All patients with stage II and III multiple myeloma were positive with 99mTc-MlBl scans at diagnosis. The pattern of positive MIBI accumulation was diffuse in 13 (52%) patients, focal in 4 (16%) and combined focal and diffuse in 6 (24%) patients. The intensity of 99mTc-MIBI correlated with disease activity as determined by lactate dehydrogenase (LDH), number of plasma cells in bone marrow and serum electrophoresis. There was a direct correlation between 99mTc-MIBI scan result and clinical outcome of patients following 6 courses of chemotherapy. Sensitivity and specificity of 99mTc-MIBI scintigraphy in detecting myeloma bone lesions were 92% and 90% respectively. Conclusion: 99mTc-MIBI scintigraphy is a reliable method to evaluate bone marrow activity in patients with multiple myeloma and follow-up of myeloma bone lesions

Comparison of Tc-99m-tetrofosmin and Tc-99m-MIBI scintimammography in differential diagnosis of breast mass

International Nuclear Information System (INIS)

Park, Jung Mi; Choi, Joon Young; Lee, Kyung Han; Choi, Yong; Choe, Yearn Seong; Kim, Sang Eun; Kim, Byung Tae; Nam, Seok Jin; Yang, Jeong Hyun

2000-01-01

Tc-99m-MIBI (MIBI) and Tc-99m-Tetrofosmin (TF) are commonly used for scintimammog (SMM). We compared the diagnostic ability of SMM using Tc-99m-MIBI and Tc-99m-TF for the differ diagnosis of breast mass. The study subjects were comprised of 123 breast lesior 86 normal breasts of 114 patients who underwent SMM. Bilateral prone images and anterior supine images obtained at 5 minutes and 1 or 3 hours after intravenous injection of 740 MBq of either MIBI or TF. of tumors were not significantly different between the MIBI and TF groups. First, two observers independ read the SMM without clinical information (1st interpretation), then read again with information about location (2nd interpretation). Sensitivity and specificity of each radiopharmaceutical for the diagnosis of cancer were evaluated in terms of image acquisition time, tumor size, and location. The SMM sb a good agreement between two observers for 1st and 2nd interpretation, except for TF SMM at hr. For first interpretation, the sensitivities at 5 min, 1 hr, and 3 hr were not significantly different between MIE TF SMM (81.6%, 80.0%, 60.9% in MIBI vs. 88.9%, 80.6%, 42.9% in TF), although the sensitivities of images were significantly lower than 5 min images in both MIBI and TF SMM. The specificity of TF at was superior to that of MIBI (81.5%, 90.0%, 82.9% in MIBI vs. 96.7%, 100%, 90.0% in TF, p<0.01 MB TF at 5 min). For the second interpretation with information of mass location, the sensitivities at 3 hr in were significantly lower than 5 min images (86.8%, 86.7%, 78.3% in MIBI vs. 88.9%, 93.5%, 57.1% in between MIBI and TF SMM. However, there was no significant difference in the specificity (60.0%, 5 75.0% for MIBI vs. 86.7%, 100%, 100% for TF). MIBI and TF SMM showed lower sensitivities for the t with less than 1 cm than tumors with more than 1 cm. However, the location of tumors did not influence sensitivity and specificity between MIBI and TF SMM. The ability for the differential diag of breast tumor is

Scintigraphic study of palpable breast nodes with 99m Tc-tetrofosmin

International Nuclear Information System (INIS)

Pellini, Marcos Pinto; Fonseca, Lea Mirian Barbosa da; Amarante Junior, Jose Luiz de Medeiros; Fabricio, Maria Ines Menescal

1998-01-01

In Brazil, breast carcinoma has the greater incidence among women. In 1996, about 31,210 new cases were diagnosed. The purpose of this study is to determine if 99m technetium-tetrofosmin preferentially concentrates within malignant palpable breast nodes, distinguishing them from the benign lumps. Fifth-four consecutive and unsolicited women, mean age 47.5 +- 10.7 years, with palpable nodes in breast, underwent breast scintigraphy with 99m technetium-tetrofosmin and excisional biopsy or fine needle puncture within interval eight weeks. Histopathologic studies demonstrated 13 cysts, 1 cyst with local inflammation, 11 fibroadenoma, 2 fibrodysplasias, 3 fibroadenomas with high cellularity, 1 fibrocystic change with local inflammation, 23 invasive intraductal carcinomas and 1 invasive lobular carcinoma. The nodes ranged from 10 to 100 mm in greater diameter. The scintigraphic study yielded 30 true-negative cases, 24 true-positives, no false-negative and 1 false-positive. This case was a fibrocystic lump with local inflammation. Two patients had metastases in axillary lymph nodes, well detected in scintigraphy. The statistic analysis showed: sensitivity, 100%; specificity, 96.8%; accuracy, 98.2%; negative predictive value, 100%; positive predictive value, 96.0%. Nonparametric tests of Fisher and Chi-square rejected the antithesis at a confidence interval of 99.9% (p 99m technetium-tetrofosmin preferentially concentrates in malignant palpable breast nodes and can help to distinguish them from the benign tumors with with very high accuracy. (author)

Preoperative parathyroid gland localization with technetium-99m sestamibi in secondary hyperparathyroidism

International Nuclear Information System (INIS)

Pons, F.; Vidal-Sicart, S.; Fuster, D.; Herranz, R.; Torregrosa, J.V.; Sabater, L.; Fernandez-Cruz, L.

1997-01-01

Technetium-99m sestamibi scintigraphy has become a valuable tool in locating parathyroid glands in patients with primary hyperparathyroidism. The aim of this study was to evaluate its usefulness in secondary hyperparathyroidism. Twenty patients were injected intravenously with 740 MBq of 99m Tc-sestamibi and images were obtained at 15 min and 2 h post injection. All patients underwent parathyroid ultrasonography (US) as well as bilateral surgical neck exploration and 64 parathyroid glands were removed. US revealed at least one enlarged gland in 15/20 patients (75%), while 99m Tc-sestamibi scintigraphy showed focal areas of increased uptake in at least one gland in 17/20 patients (85%). When imaging results for all glands were evaluated according to surgical results, sensitivity was 54% for parathyroid scintigraphy and 41% for US, and specificity was 89% for both imaging techniques. There was a discrepancy between the two imaging modalities in 28 glands (35%). The mean surgical weight of US-positive glands (1492±1436 mg) was significantly higher than that of US-negative glands (775±703 mg) (P 99m Tc-sestamibi scintigraphy are complementary imaging techniques in the preoperative localization of abnormal parathyroid glands in patients with secondary hyperparathyroidism. The limited sensitivity of the techniques means that patients will still require bilateral neck exploration; therefore routine preoperative parathyroid scanning in renal patients is not justified. (orig.)

Preoperative nodal staging of non-small cell lung cancer using {sup 99m}Tc-sestamibi SPECT/CT imaging

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Miziara, Juliana Muniz; Rocha, Euclides Timoteo da; Miziara, Jose Elias Abrao; Garcia, Gustavo Fabene; Simoes, Maria Izilda Previato; Lopes, Marco Antonio; Kerr, Ligia Maria [Hospital de Cancer de Barretos, Barretos, SP (Brazil); Buchpiguel, Carlos Alberto, E-mail: julimiziara@ig.com.br [Faculdade de Medicina da Universidade da Sao Paulo, Hospital das Clinicas da Faculdade de Medicina da Universidade de Sao Paulo, SP (Brazil)

2011-07-01

Objectives: The proper nodal staging of non-small cell lung cancer is important for choosing the best treatment modality. Although computed tomography remains the first-line imaging test for the primary staging of lung cancer, its limitations for mediastinum nodal staging are well known. The aim of this study is to evaluate the accuracy of hybrid single-photon emission computed tomography and computed tomography using {sup 99m}Tc-sestamibi in the nodal staging of patients with non-small cell lung cancer and to identify potential candidates for surgical treatment. Methods: Prospective data were collected for 41 patients from December 2006 to February 2009. The patients underwent chest computed tomography and single-photon emission computed tomography/computed tomography examinations with {sup 99m}Tc-sestamibi within a 30-day time period before surgery. Single-photon emission computed tomography/computed tomography was considered positive when there was focal uptake of sestamibi in the mediastinum, and computed tomography scan when there was lymph nodes larger than 10 mm in short axis. The results of single-photon emission computed tomography and computed tomography were correlated with pathology findings after surgery. Results: Single-photon emission computed tomography/computed tomography correctly identified six out of 19 cases involving hilar lymph nodes and one out of seven cases involving nodal metastases in the mediastinum. The sensitivity, specificity, positive predictive value, and negative predictive value for {sup 99m}Tc-sestamibi single-photon emission computed tomography/computed tomography in the hilum assessment were 31.6%, 95.5%, 85.7%, and 61.8%, respectively. The same values for the mediastinum were 14.3%, 97.1%, 50%, and 84.6%, respectively. For the hilar and mediastinal lymph nodes, chest tomography showed sensitivity values of 47.4% and 57.1%, specificity values of 95.5% and 91.2%, positive predictive values of 90% and 57.1% and negative

Measurement of left ventricular ejection fraction using gated 99mTc-sestamibi myocardial planar images: Comparison to contrast ventriculography

International Nuclear Information System (INIS)

Parker, D.A.; Lloret, R.L.; Barilla, F.; Douthat, L.; Gheorghiade, M.

1991-01-01

Using the new myocardial perfusion agent 99mTc-sestamibi and multigated acquisition on a nuclear medicine gamma camera, the left ventricular ejection fraction (LVEF) was derived in 13 patients with coronary artery disease (CAD). Cross-sectional activity profiles were used to measure the left ventricle from end-diastolic and end-systolic images. Several different geometric methods were then utilized to derive ejection fractions from the nuclear data. Comparison of the resultant ejection fractions to those obtained from contrast ventriculography showed significant correlation for all geometric methods (P less than 0.01, Sy X x = 6.2 to 9.6). The authors conclude that in patients with CAD one or more of these simple geometric methods can provide a useful estimate of the LVEF when performing 99mTc-sestamibi multigated myocardial perfusion imaging

Assessment of Takotsubo (ampulla) cardiomyopathy using 99mTc-tetrofosmin myocardial SPECT. Comparison with acute coronary syndrome

International Nuclear Information System (INIS)

Ito, Kazuki; Katoh, Shuji

2003-01-01

We assessed Takotsubo (ampulla) cardiomyopathy compared with acute coronary syndrome (ACS) using two-dimensional echocardiography and 99m Tc-tetrofosmin myocardial SPECT. We examined 10 patients with Takotsubo cardiomyopathy and 16 with ACS at the time of emergency admission (acute phase), at three to nine days after the attack (subacute phase) and at one month after the attack (chronic phase). The left ventricle was divided into nine regions on echocardiograms and SPECT images, and the degree of abnormalities in each region was scored in five grades from normal (0) to severely abnormal (4). Coronary angiography revealed total or subtotal occlusion in patients with ACS but no stenotic legions in those with Takotsubo cardiomyopathy. The amount of ST segment elevation (mm) was 7.9±3.4 in patients with Takotsubo cardiomyopathy and 7.3±3.7 in those with ACS (N.S.). Abnormal wall motion scores on echocardiograms were 13.8±4.4, 4.4±3.8 and 1.8±2.3 during the acute, subacute and chronic phases in patients with Takotsubo cardiomyopathy, and 13.9±4.0, 11.7±3.7, 7.6±4.2, respectively in patients with ACS. The value of MB fraction of creatine phosphokinase (IU/l) was 34±23 in patients with Takotsubo cardiomyopathy and 326±98 in those with ACS (p 99m Tc-tetrofosmin myocardial SPECT were 11.4±3.2, 3.2±3.3 and 0.7±1.1 during the acute, subacute and chronic phases respectively, in patients with Takotsubo cardiomyopathy, and 15.8±4.1, 13.5±4.4, 8.2±4.4, respectively, in those with ACS. The numbers of myocardial segments that did not uptake 99m Tc-tetrofosmin during the acute phase were 0.5±0.8 and 3.6±2.8 in patients with Takotsubo cardiomyopathy and ACS, respectively. Impaired coronary microcirculation might be a causative mechanism of Takotsubo cardiomyopathy. (author)

Use of 99mTc-sestamibi Single-photon Emission Computed Tomography / X-ray Computed Tomography in the Diagnosis of Hybrid Oncocytic / Chromophobe Tumor in a Pediatric Patient.

Science.gov (United States)

Almassi, Nima; Gorin, Michael A; Purysko, Andrei S; Rowe, Steven P; Kaouk, Jihad; Allaf, Mohamad E; Campbell, Steven C; Rhee, Audrey

2018-03-01

The differential diagnosis of solid renal neoplasms in adolescence includes aggressive malignancy and indolent oncocytic tumors, which are typically indistinguishable using conventional imaging. We report the use of 99m Tc-sestamibi single-photon emission computed tomography / x-ray computed tomography (SPECT/CT) in characterizing enhancing renal neoplasms in a pediatric patient. Genetic testing suggested a hereditary syndrome associated with aggressive malignancy, whereas renal mass biopsy suggested an oncocytic tumor. 99m Tc-sestamibi SPECT/CT indicated probable oncocytomas or hybrid oncocytic / chomophobe tumors. Enucleative resection was performed with final pathology demonstrating hybrid oncocytic / chomophobe tumors. This case highlights the potential utility of 99m Tc-sestamibi SPECT/CT in characterizing indeterminate enhancing renal neoplasm in pediatric patients. Copyright © 2017 Elsevier Inc. All rights reserved.

Adsorption of technetium-99m tetrofosmin and technetium-99m furifosmin on plastic syringes

Energy Technology Data Exchange (ETDEWEB)

Bartosch, R.; Granegger, S.; Sinzinger, H. [Department of Nuclear Medicine, University of Vienna (Austria)

1998-09-01

Some groups have reported that adsorption of radiopharmaceuticals on disposable plastic syringes can reach levels of almost 50%. This high loss of radioactivity stimulated us to carry out similar studies. Our measurements were done in combination with patient studies. Therefore, we used 2-ml syringes, all of the same brand. The radioactivity in the syringe was measured immediately before and after injection. a total of 500-600 MBq technetium-99m labelled tetrofosmin or technetium-99m furifosmin was administered to 48 patients using four different injection techniques (n = 6 for each technique with each tracer): with needles, 1 min blood incubation at 22 C, 10 or 30 min after preparation of the tracer; with butterflies, 1 min blood incubation at 22 C, 10 or 30 min after preparation of the tracer. Neither in syringes nor in needles or butterflies did more than 7% of the initial radioactivity remain. The entire residual activity in syringe plus needle or syringe plus butterfly together never exceeded the 9% limit. Furthermore, in a pilot study we measured the remaining radioactivity in the vial; here, too, we found no more than 14% of total radioactivity. These findings indicate that total retention of radioactivity during elution and application of {sup 99m}Tc-tetrofosmin and {sup 99m}Tc-furifosmin with material used in our setting does not approach relevant amounts. (orig.) With 4 figs., 1 tab., 7 refs.

Detection of tumor recurrence using technetium99m-tetrofosmin brain SPECT in patients with previously irradiated brain tumors

International Nuclear Information System (INIS)

Llamas A; Reyes A; Uribe, L F; Martinez T

2004-01-01

Objective: to assess the clinical utility of brain SPECT with Tc-99m Tetrofosmin to differentiate between tumor recurrence and radionecrosis in patients with primary brain tumors previously treated with external beam radiotherapy. Materials and methods: thirteen patients with clinical or radiological suspicion of tumor recurrence were studied with brain SPECT using 20-mCi of Tc-99m Tetrofosmin. Obtained images were interpreted by consensus between two experienced observers and subsequently classified as positive or negative for tumor viability. Results were compared to those of conventional diagnostic imaging techniques. Diagnostic test values and 95% confidence intervals were quantified. Results: SPECT results included 7 true-positives, 5 true-negatives and 1 false negative result. Conclusions: Tc-99m Tetrofosmin brain SPECT night be a useful alternative to diagnose recurrent brain tumors, especially with non-conclusive clinical and radiological findings

Comparative study of gated myocardial perfusion imaging using 99Tcm-tetrofosmin and 99Tcm-sestamibi

International Nuclear Information System (INIS)

Wang Ruihua; Ruan Qiao; Sun Ke; Han Xingmin; Sun Bingqi; Xie Xinli; Cheng Bing; Chen Yanlin; Liu Baoping

2013-01-01

Objective: To compare the results of 99 Tc m -tetrofosmin (TF) and 99 Tc m -MIBI G-MPI in evaluating left ventricular myocardial perfusion and other functional parameters. Methods: TF and MIBI were both labeled by 99 Tc m and the radiochemical purities were tested. During December 2011 to May 2012, 112 patients who had examinations of CAG and echocardiograph in one week after G-MPI were divided into 99 Tc m -TF group (47 patients) and 99 Tc m -MIBI group (65 patients) by simple random sampling. Patients who suffered from severe arrhythmia, clinically suspicious of myocarditis or cardiomyopathy were excluded. The research was approved by the ethics committee, and all patients signed informed consents. One-day 99 Tc m -TF G-MPI and two-day 99 Tc m -MIBI G-MPI were performed. The left ventricular functional parameters were acquired automatically by Cedars quantitative gated SPECT (QGS) software, including LVEF, EDV, ESV, peak filling rate (PFR), peak ejection rate (PER) and phase standard difference (SD). The data were analyzed using χ 2 test, two-sample t test, paired t test and linear correlation analysis by SPSS 17.0. Results: The radiochemical purities of 99 Tc m -TF and 99 Tc m -MIBI were (97.5±0.4) % and (99.1±0.2) % respectively. The coincidence rates of 99 Tc m -TF and 99 Tc m -MIBI G-MPI with CAG were 88.9% (40/45) and 90.5% (57/63), respectively. There was no significant difference between G-MPI results of the two agents (χ 2 =0.389, P>0.05). There was also no significant difference between left ventricular functional parameters of the two agents (LVEF:(62.60±13.56)% vs (60.52±7.08)%, t=0.940; EDV: (103.3±17.29) ml vs (98.52±19.37) ml, t=1.348; ESV: (41.73±12.69) ml vs (46.05±10.81) ml, t=0.851; PER: (2.73±0.67)EDV/s vs (2.61±1.04) EDV/s, t=0.725; PFR: (2.13±0.80) EDV/s vs (2.07±1.09) EDV/s, t=0.339; phase SD: (5.58±4.16)° vs (5.97±4.64)°, t=0.450; all P>0.05). There was no significant difference between left ventricular functional

Comparison study of lesion localization in patients with primary and secondary hyperparathyroidism using double-phase Tc-99m sestamibi scintigraphy

International Nuclear Information System (INIS)

Jeon, Tae Joo; Lee, Jong Doo; Rhyu, Young Hoon; Park, Jung Soo; Jang, Hang Seok

1999-01-01

The purpose of this study was to evaluate and compare the scintigraphic findings and diagnostic accuracy of double-phase Tc-99m sestamibi scan in primary and secondary hyperparathyroidism (HPT). We retrospectively reviewed 16 cases of primary (18 lesions) and 11 cases of secondary HPT (44 lesions) who underwent Tc-99m-sestamibi scan before the surgical intervention. Scan was performed using LEM camera (Siemens, Germany ) after the injection of 740MBq of Tc-99m sestamibi. Routine image consisted of baseline and 3-hour delayed images and each image was obtained using both parallel and pine hole collimator. The study population was 27 patients (male/ females=5/22, age: 49.1±10.8). Eighteen lesions of primary HPT consisted of 13 adenomas and 5 hyperplasias, while while all lesions of secondary but only 2 lesions of 5 hyperplasias, while all lesions of secondary HPT were hyperplasias. Among the case of primary HPT, we could detect all the lesions of 13 adenomas but only 2 lesions of 5 hyperplasias (40%) could be detected by double phase scintigraphy. Three cases of primary lesion showed decreased uptake in delayed images compared with baseline. The sensitivity, specificity, positive predictive value and accuracy of primary and secondary HPT were 58.5% (10/17), 83.3% (10/12), 83.3%(10/12), 75.9%(22/29), and 37.5%(15/40), 50% (2/4), 88.2% (15/17), 38.6% (17/44), respectively. Overall sensitivity, specificity, positive predictive value and accuracy were 43.9% (25/57), 75%(12/16), 86.2% (25/29), and 53.4% (39/73). There were no statistical difference between the weight of primary and secondary HPT lesion (p>0.05). Tc-99m sestamibi scan is fairly good modality to detect parathyroid lesion in patient with primary HPT before the surgical intervention. However, since some of cases may reveal decreased uptake in delayed image, a careful attention to the findings of baseline images may be helpful. Still the low accuracy of sestamibi scan in diagnosis of secondary HPT prohibits

{sup 99m}Tc sestamibi imaging. Can it be a useful substitute for hepatobiliary scintigraphy in infantile jaundice?

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Sadeghi, R.; Kakhki, V.R.D.; Zakavi, R. [Mashhad Univ. of Medical Sciences (Iran). Nuclear Medicine Dept.; Kianifar, H.R. [Mashhad Univ. of Medical Sciences (Iran). Paediatric Dept.; Ansari, K. [Tehran Univ. of Medical Sciences (Iran). Nuclear Medicine Dept.

2009-07-01

Hepatobiliary scintigraphy is an integral part in the diagnostic work-up of the neonatal cholestasis syndrome. However, less than optimal specificity is its major disadvantage. Differentiation between biliary atresia and neonatal hepatitis is nearly impossible in some cases with poor hepatocellular function. {sup 99m}Tc sestamibi (MIBI) is a cationic lipophilic agent which is a substrate of P-glycoprotein. This glycoprotein is normally expressed in biliary canalicular surfaces of hepatocytes. This property provides a hepatic excretory mechanism which is different from bilirubin excretion. In this study we evaluated the value of {sup 99m}Tc MIBI in differential diagnosis of neonatal cholestasis. 20 infants with a mean age of 2.41 months (range, 0.1-5 months) were included in the study. Ten infants turned out to have extrahepatic biliary atresia and the other ten had neonatal hepatitis. Hepatobiliary (with {sup 99m}Tc BrIDA) and {sup 99m}Tc MIBI scintigraphy were performed for all the patients. {sup 99m}Tc MIBI scintigraphy has shown bowel activity in all patients, including the patients with biliary atresia. Hepatobiliary scintigraphy revealed bowel activity only in five patients with neonatal hepatitis. Bowel visualization with {sup 99m}Tc MIBI may be seen in patients with biliary atresia and {sup 99m}Tc MIBI has limited value in differential diagnosis of neonatal cholestasis. (orig.)

Use of quantitative SPECT/CT reconstruction in 99mTc-sestamibi imaging of patients with renal masses.

Science.gov (United States)

Jones, Krystyna M; Solnes, Lilja B; Rowe, Steven P; Gorin, Michael A; Sheikhbahaei, Sara; Fung, George; Frey, Eric C; Allaf, Mohamad E; Du, Yong; Javadi, Mehrbod S

2018-02-01

Technetium-99m ( 99m Tc)-sestamibi single-photon emission computed tomography/computed tomography (SPECT/CT) has previously been shown to allow for the accurate differentiation of benign renal oncocytomas and hybrid oncocytic/chromophobe tumors (HOCTs) apart from other malignant renal tumor histologies, with oncocytomas/HOCTs showing high uptake and renal cell carcinoma (RCC) showing low uptake based on uptake ratios from non-quantitative single-photon emission computed tomography (SPECT) reconstructions. However, in this study, several tumors fell close to the uptake ratio cutoff, likely due to limitations in conventional SPECT/CT reconstruction methods. We hypothesized that application of quantitative SPECT/CT (QSPECT) reconstruction methods developed by our group would provide more robust separation of hot and cold lesions, serving as an imaging framework on which quantitative biomarkers can be validated for evaluation of renal masses with 99m Tc-sestamibi. Single-photon emission computed tomography data were reconstructed using the clinical Flash 3D reconstruction and QSPECT methods. Two blinded readers then characterized each tumor as hot or cold. Semi-quantitative uptake ratios were calculated by dividing lesion activity by background renal activity for both Flash 3D and QSPECT reconstructions. The difference between median (mean) hot and cold tumor uptake ratios measured 0.655 (0.73) with the QSPECT method and 0.624 (0.67) with the conventional method, resulting in increased separation between hot and cold tumors. Sub-analysis of 7 lesions near the separation point showed a higher absolute difference (0.16) between QPSECT and Flash 3D mean uptake ratios compared to the remaining lesions. Our finding of improved separation between uptake ratios of hot and cold lesions using QSPECT reconstruction lays the foundation for additional quantitative SPECT techniques such as SPECT-UV in the setting of renal 99m Tc-sestamibi and other SPECT/CT exams. With robust

Usefulness of technetium-99m tetrofosmin single-photon emission computed tomography for short-term risk stratification in patients with acute chest pain in the emergency room

International Nuclear Information System (INIS)

Kawahito, Michitomo; Kondo, Makoto; Abe, Yoshiteru

2003-01-01

High-risk patients with acute coronary syndrome are difficult to distinguish from low-risk patients with chest pain in the emergency room. Technetium-99 m ( 99m Tc) tetrofosmin single-photon emission computed tomography (SPECT) was investigated to exclude high-risk patients with chest pain in the emergency room. 99m Tc-tetrofosmin SPECT was evaluated using a four-point scoring system in 228 patients (144 men, 84 women, mean age 68±12 years) with chest pain. Negative was defined as the myocardial segments with a defect score (DS) of 99m Tc-tetrofosmin; no significance (NS)), 84.9% (NS) and 60.4% (p 99m Tc-tetrofosmin SPECT is a useful method to exclude high-risk patients among patients with chest pain in the emergency room. (author)

Myocardial impairment detected by late gadolinium enhancement in hypertrophic cardiomyopathy: comparison with 99mTc-MIBI/tetrofosmin and 123I-BMIPP SPECT.

Science.gov (United States)

Hashimura, Hiromi; Kiso, Keisuke; Yamada, Naoaki; Kono, Atsushi; Morita, Yoshiaki; Fukushima, Kazuto; Higashi, Masahiro; Noguchi, Teruo; Ishibashi-Ueda, Hatsue; Naito, Hiroaki; Sugimura, Kazuro

2013-06-17

Myocardial fibrosis is considered to be an important factor in myocardial dysfunction and sudden cardiac death in hypertrophic cardiomyopathy (HCM). The purpose of this study was to compare myocardial fibrosis detected by late gadolinium enhancement (LGE) on cardiac MRI with myocardial perfusion and fatty acid metabolism assessed by single photon emission computed tomography in HCM. We retrospectively evaluated 20 consecutive HCM patients (female, 7; mean age, 53.4 years) who underwent LGE, technetium-99m methoxyisobutylisonitrile/tetrofosmin (99mTc-MIBI/tetrofosmin), and iodine-123 beta-methyl-iodophenylpentadecanoic acid (123I-BMIPP) imaging. We calculated the myocardium-to-lumen signal ratio (M/L) for LGE in 17 segments based on the American Heart Association statement. Scoring of 99mTc-MIBI/tetrofosmin (PI) and 123I-BMIPP (BM) was performed for each segment using a 5-point scale (0, normal; 4, highly decreased). Nineteen of 20 patients (95%) and 153 of 340 segments (45%) showed LGE. M/Ls were 0.42±0.16, 0.55±0.17, and 0.65±0.24 in PI0/BM0, PI0/BM1-4 and PI1-4/BM1-4, respectively. All M/Ls were significantly higher than that of a normal control (0.34±0.14) (pacid metabolism, and is more strongly associated with disorders of fatty acid metabolism than with perfusion abnormalities. M/L may be a useful indicator of disease severity.

Effect of verapamil on cellular uptake of Tc-99m MIBI and tetrofosmin on several cancer cells

International Nuclear Information System (INIS)

Kim, Dae Hyun; Yoo, Jung Ah; Bae, Jin Ho; Jeong, Shin Young; Suh, Myung Rang; Ahn, Byeong Cheol; Lee, Kyu Bo; Lee, Jae Tae

2004-01-01

Cellular uptake of 99 mTc-sestamibi (MIBI) and 99 mTc-tetrofosmin (TF) is low in cancer cells expressing multidrug resistance(MDR) by p-glycoprotein(Pgp) or multidrug related protein(MRP). Verapamil is known to increase cellular uptake of MIBI in MDR cancer cells, but is recently reported to have different effects on tracer uptake in certain cancer cells. This study was prepared to evaluate effects of verapamil on cellular uptake of MIBI and TF in several cancer cells. Cellular uptakes of Tc-99m MIBI and TF were measured in erythroleukemia K562 cell, breast cancer MCF7 cell, and human ovarian cancer SK-OV-3 cells, and data were compared with those of doxorubicin-resistant K562(Ad) cells. RT-PCR and Western blot analysis were used for the detection of mdr1 mRNA and Pgp expression, and to observe changes in isotypes of PKC enzyme. Effects of verapamil on MIBI and TF uptake were evaluated at different concentrations upto 200 μM at 1*10 6 cells/ m l at 37.deg.C. Radioactivity in supernatant and pellet was measured with gamma counter to calculate cellular uptake ratio. Toxicity of verapamil was measured with MTT assay. Cellular uptakes of MIBI and TF were increased by time in four cancer cells studied. Co-incubation with verapamil resulted in an increase in uptake of MIBI and TF in K562(Adr) cell at a concentration of 100 μM and the maximal increase at 50 μM was 10-times to baseline. In contrast, uptakes of MIBI and TF in K562, MCF7m SK-OV3 cells were decreased with verapamil treatment at a concentration over 1 μM. With a concentration of 200 μM verapamil, respectively. Cellular uptakes of MIBI and TF in MCF7 and SK-OV-3 cells were not changed with 10μM, but were also decreased with verapamil higher than 10μM, resulting 40% and 5% of baseline at 50 μM. MTT assay of four cells revealed that K562, MCF7, SK-OV3 were not damaged with verapamil at 200 μM. Although verapamil increases uptake of MIBI and TF in MDR cancer cells, cellular uptakes were further decreased

Role of 99mTc-Tetrofosmin scintimammography in diagnosis of breast cancer patients

International Nuclear Information System (INIS)

Jaukovic, L.J.; Spaic, R.

2004-01-01

Full text: 99mTc Tetrofosmin is a cationic complex developed for myocardial perfusion imaging, also used in diagnosis of patients with various malignancies. The aim of this study was to compare the diagnostic accuracy of 99mTc Tetrofosmin scintimammography (SMM) in detection of primary breast cancer with that of X-ray mammography (MM). Eighty-five patients with suspicious mammographic and/or sonographic findings were referred to our department for SMM. Out of these, 28 female patients (mean age 52.4 years) with 30 breast lesions suspicious for malignancy were included in the study. All the 28 patients underwent, MM, SMM and biopsy/surgery for final histological diagnosis. 555 MBq of 99mTc Tetrofosmin was injected intravenously in the arm contra lateral to the side of suspicious lesion. Seven minutes static scans of at least two million counts were obtained using a large field of view gamma camera coupled with a low energy high-resolution collimator. Planar left lateral and right lateral images were acquired in prone position. An anterior image of chest and axillary region in the supine position with the hands raised above the head was also acquired. SMM scans were interpreted visually vis-a-vis the tracer uptake in tumor and background tissue, as well as the homogeneity of tracer distribution. SMM scans and mammograms of 30 lesions were compared with the definitive histopathological findings using decision matrix and the results were expressed as: sensitivity, specificity, accuracy, positive predictive value (PPV) and negative predictive value (NPV). Increased tracer uptake on SMM was noticed in 23 lesions with 19/20 proved to be malignant. The smallest lesion measured only 0.6 cm (infiltrating ductal arcinoma) the biggest one was 5.0 cm in diameter (Cystosarcoma phylode-malignant type). Infiltrating lesions with central necrosis showed diffuse inhomogeneously intense tracer uptake on SMM. In one patient SMM scan presented multifocality of disease while MM showed

Thrombolytic therapy for myocardial infarction: Assessment of efficacy by myocardial perfusion imaging with technetium-99m sestamibi

International Nuclear Information System (INIS)

Wackers, F.J.

1990-01-01

Technetium-99m (Tc-99m) sestamibi has been used to evaluate the efficacy of thrombolytic therapy. Improved image quality due to the higher photon energy of Tc-99m and the increased allowable doses of this radiopharmaceutical along with its lack of redistribution makes Tc-99m sestamibi an acceptable imaging agent for such studies. This imaging agent was used for serial quantitative planar and tomographic imaging to assess the initial risk area of infarction, its change over time and the relation to infarct-related artery patency in patients with a first acute myocardial infarction. Twenty-three of 30 patients were treated with recombinant tissue-type plasminogen activator (rt-PA) within 4 hours after onset of acute chest pain. Seven patients were treated in the conventional manner and did not receive thrombolytic therapy. The initial area at risk varied greatly both in patients treated with rt-PA and in those who received conventional therapy. Patients with successful thrombolysis and patient infarct arteries had a significantly greater reduction of Tc-99m sestamibi defect size than patients who had persistent coronary occlusion. Serial imaging with Tc-99m sestamibi could find important application in future clinical research evaluating the efficacy of new thrombolytic agents. Direct measurements of the amount of hypoperfused myocardium before and after thrombolysis could provide rapid and unequivocal results using fewer patients and avoiding the use of mortality as an end point. This approach has not yet been widely tested in the clinical arena

Technetium 99m SESTAMIBI myocardial perfusion imaging: Comparison between treadmill, dipyridamole and trans-oesophageal atrial pacing 'stress' tests in normal subjects

International Nuclear Information System (INIS)

Primeau, M.; Taillefer, R.; Lambert, R.; Essiambre, R.; Honos, G.

1991-01-01

The purpose of this study was to determine the blood clearance, myocardial uptake and heart/lung and heart/liver ratios of technetium 99m methoxyisobutylisonitrile ( 99m Tc-SESTAMIBI) following 3 different types of cardiac stimulation in normal subjects: Treadmill stress (STRESS), intravenous administration of dipyridamole (DIP) and trans-oesophageal atrial pacing (TAP). Ten normal volunteers were submitted to 3 injections of 99m Tc-SESTAMIBI (10 mCi/70 kg, separated by an interval of 7 days) following STRESS (standard Bruce protocol), DIP (0.142 mg/kg.min during 4 min) and TAP procedures. Blood samples were collected from 1 to 60 min after each 99m Tc-SESTAMIBI injection. Planar imaging was performed at 5, 30 and 60 min. Blood retention (percentage of injected dose at 1 min) was 56%±4%, 24%±4% and 38%±6% for STRESS, DIP and TAP, respectively (P 99m Tc-SESTAMIBI. (orig.)

Assessment of area at risk and efficacy of treatment in patients with acute coronary syndrome using 99Tc tetrofosmin imaging in humans

International Nuclear Information System (INIS)

Matsuo, Hitoshi; Watanabe, Sachiro; Nishida, Yoshio

1993-01-01

The determination of the myocardium at risk before intervention and the change in that region after intervention constitute a promising measurement tool for the assessment of acute therapy. A new 99m Tc labeled myocardial blood flow tracer, 99m Tc tetrofosmin, is expected to enable the evaluation of myocardium at risk because of the absence of redistribution. This preliminary study was performed in 9 patients with acute coronary syndrome (4 unstable angina and 5 acute myocardial infarction) to investigate whether recovery of perfusion by tetrofosmin imaging parallels mechanical improvement. Tetrofosmin imaging was performed acutely and 3-30 days later. Visual analysis of defect severity was assessed in both studies. Segments with improvement in perfusion were accompanied by significant wall motion recovery compared with normal and unimproved segments (ΔWMI: normal segments 0.40±0.67, improved segments 1.79±0.68, unimproved segments -0.15±0.16, p 99m Tc tetrofosmin imaging is a useful method for the assessment of the myocardial area at risk and the efficacy of acute therapy in acute myocardial infarction and unstable angina. (author)

Quantitative exercise technetium-99m tetrofosmin myocardial tomography for the identification and localization of coronary artery disease

International Nuclear Information System (INIS)

Sullo, P.; Cuocolo, A.; Nicolai, E.; Cardei, S.; Nappi, A.; Squame, F.; Covelli, E.M.; Pace, L.; Salvatore, M.

1996-01-01

The aim of this study was to evaluate the accuracy of quantitative 1-day exercise-rest technetium-99m tetrofosmin tomography in the identification of patients with coronary artery disease (CAD) and in the detection of individual stenosed coronary vessels. Sixty-one patients with suspected CAD who underwent coronary angiography and 13 normal volunteers were studied. All patients were submitted to two i.v. injections of 99m Tc-tetrofosmin, one at peak exercise (370 MBq) and the other (1110 MBq) at rest 3 h after exercise (images 15-30 min after injection for both studies). All patients with CAD (≥50% luminal stenosis) (n=50) had an abnormal 99m Tc-tetrofosmin tomogram. Only one patient without significant coronary narrowing showed abnormal findings. Overall senstivity, specificity and diagnostic accuracy in the detection of individual stenosed vissels were 77%, 93% and 85%, respectively. Sensitivity and diagnostic accuracy in the identification of individuals stenosed coronary vessels were significantly higher (P 75%). (orig.)

The value and throughput of rest Thallium-201/stress Technetium -99m sestamibi dual-isotope myocardial SPECT.

Science.gov (United States)

Okudan, Berna; Smitherman, Thomas C

2004-06-01

Myocardial perfusion scintigraphy is an established method in cardiology for the diagnosis and evaluation of coronary artery disease (CAD). Thallium-201 and Tc-99m sestamibi myocardial perfusion imaging has been widely accepted as non-invasive diagnostic procedure for detection of CAD, risk stratification and myocardial viability assessment. But, standard Tl-201 redistribution and same day or 2-day rest/stress Tc-99m sestamibi protocols are time-consuming. Hence, the dual isotope rest thallium-201/stress technetium-99m sestamibi gated single-photon emission tomography protocol has gained increasing popularity for these applications. Combining the use of thallium-201 with technetium-99m agents permits optimal image resolution and simultaneous assessment of viability. Dual-isotope imaging may be separate or simultaneous acquisition set-up. The more rapid completion of these studies is appreciated as an advantage by patients, technologists, interpreting and referring physicians, nurses and hospital management. Simultaneous imaging has the potential advantages of precise pixel registration and artifacts, if present, are identical in both thallium and sestamibi, and require only one set of imaging. Also, there are some disadvantages of spillover of activity from the Tc-99m to the Tl-201 window. Fortunately, despite this problem it can be overcome. Separate acquisition dual isotope also has some disadvantages. Difference in defect resolution in attenuation and scatter between T-201 and Tc-99m sestamibi potentially results in interpretation problems. But, studies about cost-effectiveness of dual isotope imaging showed that some selective elimination of the rest studies may decrease the cost of the nuclear procedures and should be considered in the current care health system.

Sensitivity and Specificity of Dual-Isotope 99mTc-Tetrofosmin and 123I Sodium Iodide Single Photon Emission Computed Tomography (SPECT) in Hyperparathyroidism.

Science.gov (United States)

Sommerauer, Michael; Graf, Carmen; Schäfer, Niklaus; Huber, Gerhard; Schneider, Paul; Wüthrich, Rudolf; Schmid, Christoph; Steinert, Hans

2015-01-01

Despite recommendations for 99mTc-tetrofosmin dual tracer imaging for hyperparathyroidism in current guidelines, no report was published on dual-isotope 99mTc-tetrofosmin and 123I sodium iodide single-photon-emission-computed-tomography (SPECT). We evaluated diagnostic accuracy and the impact of preoperative SPECT on the surgical procedures and disease outcomes. Analysis of 70 consecutive patients with primary hyperparathyroidism and 20 consecutive patients with tertiary hyperparathyroidism. Imaging findings were correlated with surgical results. Concomitant thyroid disease, pre- and postoperative laboratory measurements, histopathological results, type and duration of surgery were assessed. In primary hyperparathyroidism, SPECT had a sensitivity of 80% and a positive predictive value of 93% in patient-based analysis. Specificity was 99% in lesion-based analysis. Patients with positive SPECT elicit higher levels of parathyroid hormone and higher weight of resected parathyroids than SPECT-negative patients. Duration of parathyroid surgery was on average, approximately 40 minutes shorter in SPECT-positive than in SPECT-negative patients (89 ± 46 vs. 129 ± 41 minutes, p = 0.006); 86% of SPECT-positive and 50% of SPECT-negative patients had minimal invasive surgery (p = 0.021). SPECT had lower sensitivity (60%) in patients with tertiary hyperparathyroidism; however, 90% of these patients had multiple lesions and all of these patients had bilateral lesions. Dual-isotope SPECT with 99mTc-tetrofosmin and 123I sodium iodide has a high diagnostic value in patients with primary hyperparathyroidism and allows for saving of operation time. Higher levels of parathyroid hormone and higher glandular weight facilitated detection of parathyroid lesion. Diagnostic accuracy of preoperative imaging was lower in patients with tertiary hyperparathyroidism.

Osteosclerotic and osteolytic manifestations of hyperparathyroidism in a case of Tc99m SestaMIBI positive parathyroid adenoma

International Nuclear Information System (INIS)

Das, Kalpa Jyoti; Sehgal, Aditi Khurana; Jaiman, Ashish; Sethi, Ravinder Singh

2005-01-01

Primary hyperparathyroidism is the first differential diagnosis when a patient presents with asymptomatic hypercalcemia. The symptoms of hyperparathyroidism can be as grave as skeletal, cardiovascular, and neuropsychological changes. Skeletal manifestations are relatively common, and patient may present with generalized or focal bone pains, fragility fractures, subperiosteal bone resorption, and osteolytic lesions like brown tumors and salt and pepper appearance of the skull. However, focal osteosclerotic lesions of the skull are rare findings in hyperparathyroidism. Only a few cases of associated osteosclerosis are reported in the literature. Here, we report a case of Tc99m SestaMIBI positive parathyroid adenoma with coexisting osteolytic and osteosclerotic skull lesions on Tc99m methylene diphosphonate bone scan

Analysis of equivalent dose (H) starting from the exposition (X) received for patient families in myocardial perfusion study with {sup 99m}Tc-Sestamibi; Analisis de dosis equivalente (H) a partir de la exposicion (X) recibida por familiares de pacientes en estudio de perfusion miocardica con {sup 99m}Tc-Sestamibi

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Martinez H, I.; Vazquez E, R.; Jimenez A, L., E-mail: irmarinc@yahoo.com.m [Instituto Nacional de Cardiologia Ignacio Chavez, Departamento de Cardiologia Nuclear, Juan Badiano No. 1, Colonia Seccion XVI, 14080 Mexico D. F. (Mexico)

2010-09-15

The myocardial perfusion study with {sup 99m}Tc-Sestamibi has the major indication frequency for the coronary arterial illness diagnostic, due to its high sensibility and specificity. The patient families that are exposed to this study also receive the radiation of the injected radiopharmaceutical. The punctual source model (Psm) is generally used for the absorbed dose calculation of the radiation coming from patients under any procedure with radiopharmaceuticals. The objective of this study was to compare the equivalent doses calculated theoretically (Dat) by means of Psm, regarding the measurements that routinely are made by means of a detector Geiger (Dam), as well as to quantify the maxim equivalent dose to which they are exposed the families of the subjected patients to this procedure. 30 voluntary patients were evaluated with clinical indication for myocardial perfusion study with {sup 99m}Tc-Sestamibi with acquisition protocol of 1 day: Rest-effort, with dose of 15-30 mCi (555-1110 mBq) respectively. Immediate to each injection of {sup 99m}Tc-Sestamibi was calculated the Dat, using the equation that the Psm describes, considering a distance of 1 meter; and the exposition speed was measured by means of a detector Geiger at a distance 1 meter to the heart height. The measurements comparison (Dat vs Dam) was realized by means of the test statistical t-student for independent samples, considering a significance level p{<=}0.05. For the data of the second injection, was realized a regression analysis to evaluate the lineal correlation among both measurements. Immediately after the injection of 15 mCi (555 mBq) of {sup 99m}Tc-Sestamibi, the values of the Dam (1.37{+-}0.43 mrem, 13.7{+-}4.3 {mu}Sv) they differ significantly of the Dat (1.04 mrem, p<0.05) (10.4 {mu}Sv). The second injection of 30 mCi (1110 mBq) of {sup 99m}Tc-Sestamibi was carried out in an average time of 2.57{+-}0.02 hr, having the patients group a calculated initial activity of 11.14{+-}0.76 m

Prevalence and pattern of abnormal myocardial perfusion in patients with isolated coronary artery ectasia: study by 99mTc-sestamibi radionuclide scintigraphy.

Science.gov (United States)

Ismail, Ahmed M; Rayan, Mona; Adel, Amr; Demerdash, Salah; Atef, Mohamed; Abdallah, Mohamed; Nammas, Wail

2014-02-01

We explored the prevalence and pattern of abnormal myocardial perfusion in patients with isolated coronary artery ectasia (CAE), as demonstrated by (99m)Tc-sestamibi scintigraphy. Prospectively, we enrolled 35 patients with angiographically documented CAE and no significant coronary obstruction, who underwent elective coronary angiography. Patients underwent Stress-rest (99m)Tc-sestamibi scintigraphy within 4 days of coronary angiography. They were divided into 2 groups: group I: with normal perfusion scan; and group II: with reversible perfusion defects. The mean age was 49.6 ± 6.9 years; 34 (97.1 %) were males. Seventy-nine (75.2 %) arteries were affected by CAE. Among 79 arteries affected by CAE, affection was diffuse in 37 (46.8 %). Thirteen (37.1 %) patients had normal perfusion scan (group I), whereas 22 (62.9 %) had reversible perfusion defects (group II). Among 22 patients with reversible perfusion defects, 20 (90.9 %) had mild and 2 (9.1 %) had moderate ischemia. Among 49 myocardial segments with reversible perfusion defects, 22 (44.9 %) were basal, 18 (36.7 %) mid-, and 9 (18.4 %) apical segments. Diffuse CAE was significantly more prevalent in group II versus group I, in all 3 major coronary arteries (p < 0.05 for all). In patients with isolated CAE who underwent elective coronary angiography, reversible perfusion defects demonstrated by (99m)Tc-sestamibi scintigraphy were rather prevalent, mostly mild, more likely to affect the basal and mid-segments of the myocardium, and more frequently associated with diffuse ectasia.

Analysis of equivalent dose (H) starting from the exposition (X) received for patient families in myocardial perfusion study with 99mTc-Sestamibi

International Nuclear Information System (INIS)

Martinez H, I.; Vazquez E, R.; Jimenez A, L.

2010-09-01

The myocardial perfusion study with 99m Tc-Sestamibi has the major indication frequency for the coronary arterial illness diagnostic, due to its high sensibility and specificity. The patient families that are exposed to this study also receive the radiation of the injected radiopharmaceutical. The punctual source model (Psm) is generally used for the absorbed dose calculation of the radiation coming from patients under any procedure with radiopharmaceuticals. The objective of this study was to compare the equivalent doses calculated theoretically (Dat) by means of Psm, regarding the measurements that routinely are made by means of a detector Geiger (Dam), as well as to quantify the maxim equivalent dose to which they are exposed the families of the subjected patients to this procedure. 30 voluntary patients were evaluated with clinical indication for myocardial perfusion study with 99m Tc-Sestamibi with acquisition protocol of 1 day: Rest-effort, with dose of 15-30 mCi (555-1110 mBq) respectively. Immediate to each injection of 99m Tc-Sestamibi was calculated the Dat, using the equation that the Psm describes, considering a distance of 1 meter; and the exposition speed was measured by means of a detector Geiger at a distance 1 meter to the heart height. The measurements comparison (Dat vs Dam) was realized by means of the test statistical t-student for independent samples, considering a significance level p≤0.05. For the data of the second injection, was realized a regression analysis to evaluate the lineal correlation among both measurements. Immediately after the injection of 15 mCi (555 mBq) of 99m Tc-Sestamibi, the values of the Dam (1.37±0.43 mrem, 13.7±4.3 μSv) they differ significantly of the Dat (1.04 mrem, p 99m Tc-Sestamibi was carried out in an average time of 2.57±0.02 hr, having the patients group a calculated initial activity of 11.14±0.76 mCi (412.2±28.12 mBq). Differences were not observed statistically significant between the Dam (2.76±0

P-gp and MRP1 Expression in Parathyroid Tumors Related to Histology, Weight and Tc-99m-Sestamibi Imaging Results

NARCIS (Netherlands)

Jorna, F. H.; Hollema, H.; Hendrikse, H. N.; Bart, J.; Brouwers, A. H.; Plukker, J. T. M.

Objective: P-glycoprotein (P-gp) and multidrug resistance-associated protein (MRP) are membrane efflux pumps that may have a role in the kinetics of Tc-99m-sestamibi (MIBI) in parathyroid tumors. P-gp and MRP1 expression in parathyroid tumors was studied and related to histology, weight and pre- and

Technetium-99m sestamibi single-photon emission tomography detects subclinical myocardial perfusion abnormalities in patients with systemic lupus erythematosus

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Schillaci, O. [Nuclear Medicine, University of l`Aquila (Italy); Lagana, B.; Gentile, R.; Tubani, L.; Baratta, L. [Department of Clinical Medicine, University ``La Sapienza``, Rome (Italy); Danieli, R.; Scopinaro, F. [Section of Nuclear Medicine, Department of Experimental Medicine and Pathology, University ``La Sapienza``, Rome (Italy)

1999-07-01

In patients with systemic lupus erythematosus, involvement of the cardiovascular system is the third leading cause of death. However, although autopsy studies have demonstrated a high incidence of abnormalities in both the myocardium and coronary vessels, clinical manifestations have been reported in only a small percentage of cases. The aim of this study was to evaluate myocardial perfusion in asymptomatic lupus patients using technetium-99m sestamibi single-photon emission tomography (SPET). Twenty-eight patients without overt cardiac involvement and risk factors were studied with {sup 99m}Tc-sestamibi SPET at rest and after dipyridamole infusion. Perfusion abnormalities were detected in 18 cases: six had persistent defects, three had reversible defects, seven had both persistent and reversible defects, and two showed rest defects which normalized on dipyridamole images (``reverse redistribution pattern``). Coronary angiography was performed in eight patients with positive {sup 99m}Tc-sestamibi SPET, and showed normal epicardial vessels in all the cases. These results indicate that {sup 99m}Tc-sestamibi SPET reveals a high prevalence (18 out of 28 patients in this study, i.e. 64%) of myocardial perfusion abnormalities in asymptomatic lupus patients, probably due to the primary immunological damage of this autoimmune disease. In conclusion, rest/dipyridamole {sup 99m}Tc-sestamibi SPET can be a useful non-invasive method to identify subclinical myocardial involvement in systemic lupus erythematosus, and patients potentially at risk of later cardiac events. (orig.) With 2 figs., 2 tabs., 21 refs.

Technetium-99m sestamibi single-photon emission tomography detects subclinical myocardial perfusion abnormalities in patients with systemic lupus erythematosus

International Nuclear Information System (INIS)

Schillaci, O.; Lagana, B.; Gentile, R.; Tubani, L.; Baratta, L.; Danieli, R.; Scopinaro, F.

1999-01-01

In patients with systemic lupus erythematosus, involvement of the cardiovascular system is the third leading cause of death. However, although autopsy studies have demonstrated a high incidence of abnormalities in both the myocardium and coronary vessels, clinical manifestations have been reported in only a small percentage of cases. The aim of this study was to evaluate myocardial perfusion in asymptomatic lupus patients using technetium-99m sestamibi single-photon emission tomography (SPET). Twenty-eight patients without overt cardiac involvement and risk factors were studied with 99m Tc-sestamibi SPET at rest and after dipyridamole infusion. Perfusion abnormalities were detected in 18 cases: six had persistent defects, three had reversible defects, seven had both persistent and reversible defects, and two showed rest defects which normalized on dipyridamole images (''reverse redistribution pattern''). Coronary angiography was performed in eight patients with positive 99m Tc-sestamibi SPET, and showed normal epicardial vessels in all the cases. These results indicate that 99m Tc-sestamibi SPET reveals a high prevalence (18 out of 28 patients in this study, i.e. 64%) of myocardial perfusion abnormalities in asymptomatic lupus patients, probably due to the primary immunological damage of this autoimmune disease. In conclusion, rest/dipyridamole 99m Tc-sestamibi SPET can be a useful non-invasive method to identify subclinical myocardial involvement in systemic lupus erythematosus, and patients potentially at risk of later cardiac events. (orig.)

Clinical Significance of Reverse Redistribution Phenomenon on Delayed Tc-99m Tetrofosmin Myocardial Perfusion Imaging in Patients with Acute Myocardial Infarction

International Nuclear Information System (INIS)

Park, Soon Ah; Kim, Dae Weung; Kim, Chang Guhn; Jeong, Jin Won; Kim, Nam Ho; Yun, Kyeong Ho

2009-01-01

This study was performed to investigate the clinical significance of reverse redistribution (RR) phenomenon detected on delayed Tc-99m tetrofosmin myocardial single photon emission computed tomography (SPECT) in patients with acute myocardial infarction after revascularization. A Tc-99m tetrofrosmin myocardial SPECT was performed in 67 consecutive patients after revascularization for acute myocardial infarction. Myocardial SPECT imaging was performed for early imaging at 40 min and for delayed imaging at 180 min after reinjection at myocardial stress. Regional myocardial uptakes were scored by 4-point scoring in the left ventricular wall divided into 17 segments. Reverse redistribution was defined as an increase of more than 2 point in the activity score on the delayed image. Follow-up myocardial SPECT and coronary angiography (CAG) were performed 9 months later. On myocardial SPECT performed following revascularization, RR was observed in 100 of all 319 segments (31%) and in 43 patients (64%). The abnormalities of perfusion and regional wall motion were more severe in the patients with RR compared to those without RR (p<0.05). On follow-up myocardial SPECT, the myocardial perfusion, regional wall motion, and myocardial thickness were significantly improved in the patients with RR (p<0.05) however, these changes were not significant in those without RR. There was no significant difference between the patients with RR and those without RR in the occurrence of restenosis on CAG. In patients with acute myocardial infarction, the regions showing the RR phenomenon on delayed Tc-99m tetrofosmin SPECT may reflect viable myocardium and indicate recovery of salvaged myocardium

Electrocardiographic-gated dual-isotope simultaneous acquisition SPECT using 18F-FDG and 99mTc-sestamibi to assess myocardial viability and function in a single study

International Nuclear Information System (INIS)

Matsunari, Ichiro; Matsudaira, Masamichi; Hisada, Kinichi; Kanayama, Sugako; Yoneyama, Tatsuya; Nakajima, Kenichi; Taki, Junichi; Tonami, Norihisa; Nekolla, Stephan G.

2005-01-01

Dual-isotope simultaneous acquisition single-photon emission computed tomography (DISA SPECT) with 18 F-fluorodeoxyglucose (FDG) and 99m Tc-sestamibi appears attractive for the detection of viable myocardium because it permits simultaneous assessment of glucose utilisation and perfusion. Another potential benefit of this approach is that the measurement of left ventricular (LV) function may be possible by ECG gating. The aim of this study was to test the hypothesis that both myocardial viability and LV function can be assessed by a single ECG-gated 18 F-FDG/ 99m Tc-sestamibi DISA SPECT study, based on comparison with 18 F-FDG/ 13 N-ammonia positron emission tomography (PET) and magnetic resonance imaging (MRI) as reference techniques. Thirty-three patients with prior myocardial infarction underwent ECG-gated 18 F-FDG/ 99m Tc-sestamibi DISA SPECT and 18 F-FDG/ 13 N-ammonia PET on a single day. Of these, 25 patients also underwent cine-MRI to assess LV function. The LV myocardium was divided into nine regions, and each region was classified as viable or scar using a semiquantitative visual scoring system as well as quantitative analysis. The global and regional LV function measured by gated SPECT was compared with the results of MRI. There was good agreement in respect of viability (90-96%, κ0.74-0.85) between DISA SPECT and PET by either visual or quantitative analysis. Furthermore, although both global and regional LV function measured by gated SPECT agreed with those by MRI, 99m Tc-sestamibi showed a closer correlation with MRI than did 18 F-FDG. In conclusion, ECG-gated DISA SPECT provides information on myocardial viability, as well as global and regional LV function, similar to that obtained by PET and MRI. (orig.)

Technetium-99m sestamibi imaging to predict left ventricular ejection fraction outcome after revascularisation in patients with chronic coronary artery disease and left ventricular dysfunction: comparison between baseline and nitrate-enhanced imaging

International Nuclear Information System (INIS)

Sciagra, R.; Pupi, A.; Leoncini, M.; Dabizzi, R.P.; Marcucci, G.

2001-01-01

Acceptance of technetium-99m sestamibi as a tracer of myocardial viability is growing, particularly when nitrate-enhanced imaging is used. However, few data are available on the ability of 99m Tc-sestamibi to predict the evolution of global left ventricular ejection fraction (EF). The aim of this study was to examine the ability of resting and nitrate 99m Tc-sestamibi single-photon emission tomography (SPET) to predict EF changes after revascularisation in patients who have chronic coronary artery disease with left ventricular dysfunction. Using baseline resting and nitrate 99m Tc-sestamibi SPET, we studied 61 patients scheduled for revascularisation because of left ventricular dysfunction. EF was estimated using two-dimensional echocardiography before and after the intervention. A post-revascularisation improvement of ≥5 EF units was defined as significant. Using a 13-segment model, 99m Tc-sestamibi activity was quantified and the nitrate-induced activity changes calculated. Three different criteria for detecting viability (defined as post-revascularisation reversible dysfunction) in asynergic segments were compared: (1) resting 99m Tc-sestamibi activity ≥60%; (2) nitrate 99m Tc-sestamibi activity ≥65%; and (3) nitrate-induced increase >+10% or nitrate-induced increase ≤+10% and nitrate activity ≥65%. EF increased significantly in 32 patients. The number of viable asynergic segments was significantly higher in these patients than in the remaining 29 subjects, and the difference was greater (P 99m Tc-sestamibi SPET appears able to predict the evolution of global left ventricular EF after revascularisation, thereby confirming the value of 99m Tc-sestamibi as a tracer of myocardial viability. The combination of baseline resting and nitrate imaging seems to significantly improve the diagnostic accuracy of 99m Tc-sestamibi SPET for this particular purpose. (orig.)

Detection of axillary lymph node metastases in breast carcinoma by technetium-99m sestamibi breast scintigraphy, ultrasound and conventional mammography

International Nuclear Information System (INIS)

Lam, W.W.M.; Yang, W.T.; Chan, Y.L.; Stewart, I.E.T.; Metreweli, C.; King, W.

1996-01-01

Axillary lymph node status is important in the staging of breast carcinoma. To evaluate the accuracy of technetium-99m sestamibi breast scintigraphy in detecting metastatic axillary lymph nodes as compared with other accepted imaging modalities, we performed 99m Tc-sestamibi breast scintigraphy, conventional mammography and ultrasound in 36 patients with primary untreated breast cardinoma. With histopathology as the gold standard, 99m Tc-sestamibi breast scintigraphy was found to yield true-positive results in 7 of 11 cases (64%) of axillary lymph nodes metastases and true-negative results in 18 of 20 cases (90%); it has an accuracy of 81%, a positive predictive value of 77.8% and a negative predicive value of 81.8%. (orig.)

Effect of Radioactivity of Technetium-99m on the Autosterilization Process of non-sterile Tetrofosmin Kits

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Widyastuti Widyastuti

2017-03-01

Full Text Available Technetium-99m labeled radiopharmaceutical is commonly used in nuclear medicines as a diagnostic agent, by mixing the sterile kit with Tc-99m. Manufacturing of kits requires an aseptic facility which need to be well designed and maintained according to cGMP, since mostly kits can not be terminally sterilized. Radiopharmaceuticals as pharmaceuticals containing radionuclide is assumed to have an autosterilization property, but correlation between radioactivity and capability of killing microorganisms has to be studied so far. The aim of this study is to investigate the effect of radioactivity on the autosterilization process of radiopharmaceuticals. The study was carried out by adding Tc-99m of various radioactivity into non-sterile tetrofosmin kits, then the samples were tested for sterility. Sterile tetrofosmin kit and non-sterile kit with no Tc-99m added will be used as a negative control and positive control respectively. The sterility was tested using standard direct inoculation method, by inoculating samples in culture media for both bacteria and fungi and observing qualitatively within 14 days. The results showed that the samples with radioactivity of 1, 3 and 5 mCi changed the clarity of the media to turbid, conformed with the performance of positive controls but samples with radioactivity of 10 mCi and 20 mCi did not change the clarity of the media, conformed with the performance of negative control, indicating neither growth of bacteria nor fungi. It is concluded that Tc-99m behaves as an autosterilizing agent at certain radioactivity. Therefore the preparation of Tc-99m radiopharmaceutical can be considered as terminal sterilization rather than aseptic preparation.

The effect of Tc99m Sestamibi scans during acute chest pain on clinical management

International Nuclear Information System (INIS)

Baldey, A.; Cameron, P.; Grigg, L.; Knott, J.; Better, N.

1998-01-01

Full text: The aim of this study is to assess whether the increased sensitivity and specificity of Tc99m sestamibi scans, during acute chest pain, will lead to alteration in clinical management and potential cost saving in an Australian population. Consecutive patients who presented with acute chest pain were injected 800 MBq of Tc99m sestamibi during pain (Hot MlBI) and SPECT imaging performed 1-6 hours later. The population was those only with a 'intermediate risk' of myocardial ischaemia The patients included in patients, those in the Emergency Department, and those with a previous history of cardiac disease. 25% of patients required a second, pain free study the following day to differentiate acute ischaemia from prior infarction. A question sheet was filled out by the requesting physician prior to the study indicating the likelihood of cardiac disease and the proposed management if no 'Hot MIBI' scan was available. The treatment that the patient subsequently received was ascertained from the patient's medical record. Of the 28 patients, a prediction whether to or not to proceed to coronary angiography was made in 13 patients prior to the MIBI study being performed. Of the 13, 5 would have had coronary angiography performed. and in all 5, the decision to proceed to coronary angiography was averted by the 'Hot MIBI'. Of note, 3 patients were admitted purely because of an abnormal 'Hot MIBI'. The 'Hot MIBI' was able to reduce coronary care admissions by 83% reduce all admissions by 17%, and avert coronary angiography in 38% of patients. In this intermediate risk category patient, this translates to not only admissions saved but potential cost saving

Technetium-99m sestamibi leg scintigraphy for non-invasive assessment of propionyl-l-carnitine induced changes in skeletal muscle metabolism

International Nuclear Information System (INIS)

Cittanti, C.; Colamussi, P.; Giganti, M.; Orlandi, C.; Uccelli, L.; Manfrini, S.; Azzena, G.; Piffanelli, A.

1997-01-01

Carnitine derivatives, such as propionyl-l-carnitine (PLC), have been shown to improve walking distance in patients with obstructive peripheral artery disease (PAOD). The aim of this study was to ascertain whether technetium-99m sestamibi leg scintigraphy may be a useful tool in the evaluation of changes in skeletal muscle metabolism induced by chronic therapy with PLC. Twenty patients with clinical and instrumental evidence of PAOD were randomly assigned to a 3-month period of therapy with either PLC or placebo. Rest 99m Tc-sestamibi leg scintigraphy and echo-Doppler sonography were performed on all subjects immediately before and upon completion of the treatment period. At the end of the protocol the following results were observed in patients who underwent PLC administration: (a) a significant increase in both thigh and calf 99m Tc-sestamibi uptake, in comparison with baseline values (P 99m Tc-sestamibi was demonstrated without any apparent change in regional blood flow. This fact, if proven in further studies, may suggest a role for this tracer as a non-invasive probe of tissue bioenergetics. (orig.). With 4 figs., 4 tabs

Comparison of 99mTc-sestamibi-18F-fluorodeoxyglucose dual isotope simultaneous acquisition and rest-stress 99mTc-sestamibi single photon emission computed tomography for the assessment of myocardial viability

NARCIS (Netherlands)

den Boer, Johan; Slart, R H J A; Blanksma, P K; Willemsen, Antonius; Jager, P L; Paans, A M J; Vaalburg, W; Piers, D A

Dual isotope simultaneous acquisition single photon emission computed tomography (DISA SPECT) offers the advantage of obtaining information on myocardial perfusion using Tc-sestamibi ( Tc-MIBI) and metabolism using F-fluorodeoxyglucose ( F-FDG) in a single study. The prerequisite is that the Tc-MIBI

Technetium-99m-tetrofosmin in diagnosis of breast cancer and axillary lymph node involvement

International Nuclear Information System (INIS)

Jaukovic, Dj.; Ajdinovic, B.Z.; Jankovic, Z. D.; Strbac, M.

2006-01-01

The aim of this study was to evaluate the accuracy of breast cancer seeking agent Tc-99m-Tetrofosmin in the detection of breast malignancy and axillary lymph node metastases. Twenty-eight female patients (mean age 52.4) with 30 breast lesions suspected of malignancy were enrolled in the study. All the patients underwent clinical investigation, Tc-99m Tetrofosmin scintimammography (SMM), mammography (MM) and biopsy/surgery for final histopathologic diagnosis. Patients were injected intravenously with 555 MBq of Tc-99m Tetrofosmin, cubitally, in the contralateral arm to the side of suspicious lesion. Seven minute static scans or at least 2.0 million counts were obtained using single head gamma camera (Orbiter 75, Siemens). Planar images were acquired in left and right prone lateral view as well as in the supine position for an anterior view of chest and axillary region. SMM scans of 30 breast lesions were compared to the definitive histopathology findings (HP) using decision matrix. In the group of 23 patients with positive SMM scans 19 had breast malignancy: 15 infiltrating ductal cancer, three patients with one infiltrating lobular, one papillary, one colloidal cancer and one patient with cystosarcoma phyllodes-malignant type. SMM detected primary breast malignancy with 95% sensitivity, 60% specificity and 83% accuracy. Axillary dissection was performed in 19/20 with malignant disease. The number of lymph nodes extracted and HP evaluated varied from 4 to 23 per patient. Metastatic involvement was confirmed by HP in 9 out of 20 patients. SMM detected axillary metastases with 55% sensitivity and 80% accuracy. Our results showed that SMM might be useful as a complementary test to improve the sensitivity and specificity of conventional imaging modalities, although SMM in the staging of breast carcinoma was less reliable. Further studies to evaluate the role of SMM in metastatic node involvement are necessary. (author)

Tc99m-sestamibi dosimetry in myocardial perfusion imaging

International Nuclear Information System (INIS)

Toledo, Janine M.; Trindade, Bruno M.; Campos, Tarcisio P.R.

2015-01-01

This paper addressed myocardial perfusion imaging providing a spatial dosimetric investigation of the 99m Tc-radiopharmaceutical dose distribution at the myocardium. Radiological data manipulation was performed in order to create a computational voxel model of the heart. A set of images obtained by thoracic angiotomography and abdominal aorta was set up providing anatomic and functional information for heart modeling in SISCODES code. A homogeneous distribution of 99m Tc was assumed into the cardiac muscle. Simulations of the transport of particles through the voxel and the interaction with the heart tissues were performed on the MCNP - Monte Carlo Code. The spatial dose distribution in the heart model is displayed as well as the dose versus volume histogram of the heart muscle. The present computational tools can generate spatial doses distribution in myocardial perfusion imaging. Specially, the dosimetry performed elucidates imparted dose distribution in the myocardial muscle per unit of injected 99m Tc activity, which can contribute to future deterministic effect investigations. (author)

Interest of 99mTc-sestamibi scintigraphy in the diagnosis and therapeutic orientation of parathyroid ectopia

International Nuclear Information System (INIS)

Ben Rais, N.; Ghfir, I.

2007-01-01

Full text: The presence of an ectopic parathyroid gland is the most frequent cause of persistent hyperparathyroidism. Its detection constitutes a source of topographic diagnostic difficulty particularly for purely morphological explorations. The goal of this work is to elucidate the interest of double-phase planar scintigraphy using 99mTcsestamibi in the diagnosis and the therapeutic orientation of ectopic parathyroid through a clinical case explored in Nuclear Medicine department of Ibn Sina hospital in Rabat under the directives of Professor N Ben Rais. Case report: 35-year-old patient addressed to the department for an isotopic exploration of a persistent hyperparathyroidism after subtotal parathyroidectomy. The clinical examination was without particularity contrasting with phosphocalcic metabolism disorders and an always-high parathormone rate. Echography, computed tomography and resonance magnetic nuclear imagery were not conclusive. Scintigraphic exploration was carried out after intravenous injection of 20 mCi of sestamibi-Tc99m with acquisition, in double-phase, of static images at the 20th minute then at the 2nd hour after administration of radiotracer. The scintigraphy objectified a high uptake hearth, projecting itself to the right sterno-clavicular junction individualized at the first minutes of the acquisition and confirmed by the late images. The diagnosis of an ectopic parathyroid localization was retained. A marking and tattooing of the high uptake hearth at its cutaneous zone of projection was carried out to help the surgeon to find it. Pathologic examination of the surgical specimen revealed parathyroid adenoma tissue. The evolution was marked 2 months later by a remarkable normalisation of the rate of parathormone. Discussion: Scintigraphy using 99mTc-sestamibi indicates a means of functional exploration of which the sensitivity is significantly higher than the other means of morphological imagery. It is currently considered as the most

Evaluation of myocardial viability with 99Tcm-tetrofosmin after nitrate administration: comparison with FDG PET imaging

International Nuclear Information System (INIS)

He Wei; Cuocolo, A.

2007-01-01

Objective: The purpose of this study was to assess the relationship between tetrofosmin uptake after nitrate administration and the metabolic activity assessed by 18 F-FDG PET in patients with ischemic left ventricular (LV) dysfunction. Methods: A baseline 99 Tc m -tetrofosmin SPECT at rest and a repeated study after sublingual administration of 10 mg isosorbide dinitrate within two days were undertaken in 36 patients with chronic myocardial infarction and LV dysfunction. All patients underwent metabolic PET imaging with 18 F-FDG in the following week. 99 Tc m -tetrofosmin uptake and metabolic activity in 13 segments of myocardium were measured in every patient. A 55% peak activity on tetrofosmin and 50% peak activity on FDG were used as the differential threshold in evaluating myocardial viability, and the uptakes compared with regional LV function assessed by echocardiography. Results: Fifty-three (40%) of the 131 akinetic or dyskinetic segments had reduced tracer uptake. Of those segments, 14 (26%) segments showed increased tetrofosmin uptake after nitrate intervention (>10% vs baseline), 39 (74%) segments remained no change. The sensitivity and specificity of baseline tetrofosmin SPECT for detecting preserved metabolic activity were 69% and 86%, respectively. After nitrate administration, the sensitivity increased to 81% (P 99 Tc m -tetrofosmin SPECT after nitrate administration may improve the identification of ischemic but still viable myocardium in patients with chronic ischemic LV dysfunction. (authors)

The use of ice-cream to reduce inferior and liver uptake of 99mTc Sestamibi

International Nuclear Information System (INIS)

Williams, R.C.; Jost, G.M.

2002-01-01

Aim: To determine if ice-cream has any role in reducing the main drawback of sestamibi imaging namely inferior and liver uptake of sestamibi in myocardial imaging. This inferior uptake from, Stomach, Loops of Bowel and Left Lobe of liver can make interpretation difficult Can obscure a defect in the inferior margin of the heart and Hot inferior uptake can produce false adjacent cold defect when using a Fourier kernel. Material and Methods: To remove the confounding factor of various 'stress' regimes adenosine exercise and Dobutamine, only resting Sestamibi scans were examined. Patients where Given ice cream on a stick (ice covered) just prior to injection Imaged at 90 mins post injection of 500 Mbq Tc99m Sestamibi with > 90% purity, using eccentric non-elliptical non circular orbit to maximise resolution, for 18 mins with 2 heads. Processing: Reconstruct (for this purpose) with a butterworth filter of 0.4 and a power factor of 2. Sum all coronal views: Make a rectangular ROI covering the inferior 1/2 or the myocardium. Duplicate this ROI and place at same vertical position over highest activity region of liver. Duplicate region and place immediately underneath cardiac region. Create a BGD region of interest between heart and liver. Data: Ratios of heart to liver and inferior to heart are created with and without background correction. Results: Summary: Ice cream reduces the inferior uptake of Sestamibi by 30%. Ice cream reduces the liver uptake by 14%. Conclusion: Given: The low risk of an ice cream intervention. The high acceptance by patients. The low cost. The effect on inferior uptake. The possible effect on liver uptake. I would recommend the use of Ice Cream for all Myocardial Sestamibi Imaging

Evaluation of thyroid nodules with technetium-99m tetrofosmin dual-phase scintigraphy

International Nuclear Information System (INIS)

Kresnik, E.; Gallowitsch, H.J.; Mikosch, P.; Molnar, M.; Pipam, W.; Gomez, I.; Lind, P.

1997-01-01

Technetium-99m tetrofosmin, a lipophilic cationic complex molecule, was introduced for myocardial imaging. In some biodistribution studies it has also been reported to accumulate in the thyroid gland. Our objectives were to determine which thyroid nodules retain tetrofosmin and whether preoperative evaluation of malignancy is possible. Tetrofosmin scintigraphy was performed in 57 patients with a cold thyroid nodule on previously performed pertechnetate scintigraphy. All patients had undergone ultrasonography and sonographically guided fine-needle aspiration biopsy. The tetrofosmin scintigrams were obtained 5 min (early image) and 1 h (late image) after intravenous injection of 370 MBq. Only nodules that showed clear tracer retention after 1 h in comparison with retention at 5 min were classified as TETRO positive. Nodules without late retention were classified as TETRO negative. All patients underwent surgery and the histological results were compared with the results of tetrofosmin scintigraphy. Ten out of 11 patients with thyroid carcinoma (two pT1, three pT2, five pT4) were TETRO negative. One patient with papillary carcinoma (pT2) was TETRO positive. The mean nodular to thyroid tissue (N/T) ratio for the late scan was 1.0±0.20. There were 21 patients with thyroid adenomas (seven follicular, seven microfollicular and seven oxyphilic); 15 of these patients were TETRO positive and six TETRO negative. The mean N/T ratio for the late images was 1.34±0.41. All patients with degenerative goitre (24 cases) and the one patient with Hashimoto's disease were TETRO negative after 1 h and the N/T ratio was 0.92±0.12 on the late scan. Our results indicate that 99m Tc-tetrofosmin scanning is of little value preoperatively in distinguishing thyroid carcinoma from other thyroid nodules. Tetrofosmin tends to demonstrate thyroid adenomas but does not have a routine role in the assessment of thyroid nodules. (orig.). With 2 figs., 4 tabs

Breast cancer staqging using technitium-99m sestamibi and indium-111 pentetreotide single-photon emission tomography

International Nuclear Information System (INIS)

Chiti, A.; Agresti, R.; Maffioli, L.S.; Tomasic, G.; Savelli, G.; Crippa, F.; Pilotti, S.; Greco, M.; Bombardieri, E.

1997-01-01

We evaluated the clinical usefulness of single-photon emission tomography (SPET) with technetium-99m sestamibi and indium-111 pentetrotide in breast cancer staging. Fifteen patients with clinical and/or mammographic findings suggesting Tl-2N0-l breast cancer were studied. SPET images were acquired 20 min after 99m Tc-sestamibi injection and 4 and 24 h after 111 In-pentetreotide injection. Patients underwent surgery the day after the later 111 In-pentetrotide acquisition. Pathological examination showed 16 tumours in the 15 patients, with one bilateral carcinoma. The mean tumour diamter was 18.7 mm. Metastatic axillary involment was found in 6/16 tumours, with a mean of five metastatic nodes per axillary node involment. Both tracers correctly identified 15/16 primary tumours and five of the six cases of metastatic axillary node involvement. No difference between the tracers was observed in breast cancer staging. 99m Tc-sestamibi seems to the better tracer in terms of physical characteristics, execution time and cost-effectivness. Our data suggest the future possibility of using nuclear medicine imaging to avoid axillary dissection in patiens with Tl breast cancer

Technetium-99m sestamibi leg scintigraphy for non-invasive assessment of propionyl-l-carnitine induced changes in skeletal muscle metabolism

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Cittanti, C. [Department of Nuclear Medicine, University of Ferrara (Italy); Colamussi, P. [Department of Nuclear Medicine, University of Ferrara (Italy); Giganti, M. [Department of Nuclear Medicine, University of Ferrara (Italy); Orlandi, C. [MEDCO Research, Inc., North Carolina (United States); Uccelli, L. [Department of Nuclear Medicine, University of Ferrara (Italy); Manfrini, S. [Surgical Pathology Institute, University of Ferrara (Italy); Azzena, G. [Surgical Pathology Institute, University of Ferrara (Italy); Piffanelli, A. [Department of Nuclear Medicine, University of Ferrara (Italy)

1997-07-01

Carnitine derivatives, such as propionyl-l-carnitine (PLC), have been shown to improve walking distance in patients with obstructive peripheral artery disease (PAOD). The aim of this study was to ascertain whether technetium-99m sestamibi leg scintigraphy may be a useful tool in the evaluation of changes in skeletal muscle metabolism induced by chronic therapy with PLC. Twenty patients with clinical and instrumental evidence of PAOD were randomly assigned to a 3-month period of therapy with either PLC or placebo. Rest {sup 99m}Tc-sestamibi leg scintigraphy and echo-Doppler sonography were performed on all subjects immediately before and upon completion of the treatment period. At the end of the protocol the following results were observed in patients who underwent PLC administration: (a) a significant increase in both thigh and calf {sup 99m}Tc-sestamibi uptake, in comparison with baseline values (P<0.001); (b) the absence of statistically significant modifications of Doppler blood flow indices of the lower limbs. In conclusion, after chronic administration of PLC, a significant increment in skeletal muscle uptake of {sup 99m}Tc-sestamibi was demonstrated without any apparent change in regional blood flow. This fact, if proven in further studies, may suggest a role for this tracer as a non-invasive probe of tissue bioenergetics. (orig.). With 4 figs., 4 tabs.

Technetium-99m sestamibi myocardial tomography based on dipyridamole echocardiography testing in hypertensive patients with chest pain

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Schillaci, O. [Section of Nuclear Medicine, Department of Experimental Medicine and Pathology, University ``La Sapienza``, Rome (Italy); Moroni, C. [Department of Internal Medicine, University ``La Sapienza``, Rome (Italy); Scopinaro, F. [Section of Nuclear Medicine, Department of Experimental Medicine and Pathology, University ``La Sapienza``, Rome (Italy); Tavolaro, R. [Section of Nuclear Medicine, Department of Experimental Medicine and Pathology, University ``La Sapienza``, Rome (Italy); Danieli, R. [Section of Nuclear Medicine, Department of Experimental Medicine and Pathology, University ``La Sapienza``, Rome (Italy); Bossini, A. [Department of Internal Medicine, University ``La Sapienza``, Rome (Italy); Cassone, R. [Department of Internal Medicine, University ``La Sapienza``, Rome (Italy); Colella, A.C. [Section of Nuclear Medicine, Department of Experimental Medicine and Pathology, University ``La Sapienza``, Rome (Italy)

1997-07-01

The aim of this study was to evaluate the diagnostic capability of technetium-99m sestamibi tomography based on dipyridamole echocardiography testing in hypertensives with chest pain, and to compare the scintigraphic results with those of coronary angiography, exercise electrocardiography and dipyridamole echocardiography. Forty subjects with mild to moderate hypertension, chest pain and no previous myocardial infarction were submitted to {sup 99m}Tc-sestamibi tomography (at rest and after high-dose dipyridamole echocardiography) and to exercise electrocardiography testing. At coronary angiography 22 patients (group A) had significant epicardial coronary artery disease ({>=}70% stenosis of at least one major vessel) and 18 normal main coronary vessels (group B). Dipyridamole {sup 99m}Tc-sestamibi imaging was positive in 21/22 patients of group A and in 5/18 of group B. Dipyridamole echocardiography was positive in 18/22 patients of group A and in 5/18 of group B. Exercise electrocardiography was positive in 15/22 patients of group A and in 11/18 of group B. Four out of five subjects in group B with positive results in all the tests showed a slow run-off of angiographic contrast medium, probably due to small-vessel disease. Significant epicardial coronary artery disease in hypertensives with chest pain is unlikely when dipyridamole {sup 99m}Tc-sestamibi tomography is negative. When scintigraphy is positive, either epicardial coronary artery disease or a small-vessel disease condition is possible. The association of scintigraphy with dipyridamole echocardiography testing allows the assessment of contractile function and myocardial perfusion by a single pharmacological stress. (orig./AJ). With 3 figs., 2 tabs.

Clinical usefulness of Tc-99m hexakis 2-methoxybutyl isonitrile gated SPECT in patients with dilated cardiomyopathy: retrospective analysis

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Khan, Z.R.; Khan, A.Z.

2010-01-01

Background: In Dilated cardiomyopathy the heart is enlarged and ventricles are dilated. Gated myocardial perfusion single photon emission computed tomography is considered state of the art for myocardial perfusion imaging. A retrospective analysis was conducted to evaluate patients with dilated cardiomyopathy with Tc-99m sestamibi gated myocardial perfusion single photon emission computed tomography to evaluate its clinical utility. Methods: A 10 year retrospective medical record review was done from 1991 to 2001 at Wake Forest University, North Carolina, USA. Eligibility criteria included a diagnosis of dilated cardiomyopathy and availability of coronary angiography and Tc-99m sestamibi cardiac imaging results. 26 cases were selected for the final review and inclusion in the study. The study was done with standard protocols for cardiac sestamibi imaging. Results: A total of 26 cases were included in the final analysis. Cases were divided into two main groups. Group-A included 16 patients with no correlation between Tc-99m sestamibi and cardiac catheterisation reports. Group-B included 10 patients with good correlation between the above tests. There were no significant differences between the left ventricular ejection fraction, angina history, sex distribution and diabetic status between the two groups. We applied Wilcoxon Signed Rank Test and z-test to quantify the difference between the two groups. Data was tabulated and z-test was performed. The calculated p value was <0.0001. This is significantly less than the tabulated p-value at 5% level of significance, i.e., 1.96. Significant differences exist between Group-A and Group-B. Conclusion: Tc-99m sestamibi is an excellent agent for investigating myocardial perfusion in dilated cardiomyopathy. The reversible and fixed perfusion defects (small to medium sized) seen in dilated cardiomyopathy after performance of Tc-99m sestamibi gated single photon emission computed tomography imaging may not be due to coronary

Limitations of Tc99m-MIBI-SPECT imaging scans in persistent primary hyperparathyroidism

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Witteveen, Janneke E.; Kievit, Job; Stokkel, Marcel P. M.; Morreau, Hans; Romijn, Johannes A.; Hamdy, Neveen A. T.

2011-01-01

In primary hyperparathyroidism (PHPT) the predictive value of technetium 99m sestamibi single emission computed tomography (Tc99m-MIBI-SPECT) for localizing pathological parathyroid glands before a first parathyroidectomy (PTx) is 83-100%. Data are scarce in patients undergoing reoperative

Hypoxia-induced alteration of tracer accumulation in cultured cancer cells and xenografts in mice: implications for pre-therapeutic prediction of treatment outcomes with 99mTc-sestamibi, 201Tl chloride and 99mTc-HL91

International Nuclear Information System (INIS)

Kinuya, Seigo; Yokoyama, Kunihiko; Li, Xiao-Feng; Bai, Jingming; Michigishi, Takatoshi; Tonami, Norihisa; Watanabe, Naoto; Shuke, Noriyuki; Takayama, Teruhiko; Bunko, Hisashi

2002-01-01

Weak visualization of tumours in pre-therapeutic scintigrams with technetium-99m sestamibi (MIBI) is likely a predictive sign of unfavourable tumour response to radiotherapy and chemotherapy. However, factors relating to this scintigraphic finding are not well understood. The presence of hypoxic tumour cells is one of the major reasons for therapeutic failure; consequently, we attempted to determine whether oxygenation status affects 99m Tc-MIBI accumulation in tumour cells. LS180 human colon cancer and T24 human bladder cancer cells were incubated in air or N 2 gas at 37 C. Cellular uptake of 99m Tc-MIBI was subsequently determined at 15, 60 and 120 min. Uptake of thallium-201 chloride was also assessed. Uptake of 99m Tc-HL91 was assessed as a hypoxic marker. Accumulation of the tracers in LS180 xenografts was observed in mice treated with 5 mg/kg hydralazine and compared with that in untreated mice. pO 2 in the medium and tumours was measured with O 2 microelectrodes. N 2 gas flow gradually reduced pO 2 in the cell suspension to 1-2 mmHg in 60 min. Cellular uptake of 99m Tc-MIBI in LS180 cells decreased by approximately 30% in N 2 gas in comparison to that in air throughout the study. Hypoxia had a more prominent influence on 201 Tl uptake, which displayed a reduction of approximately 60% in N 2 gas at 120 min, than on 99m Tc-MIBI uptake. On the other hand, N 2 gas induced an increase of 170% in 99m Tc-HL91 uptake at 120 min, indicating the hypoxic condition of cells. The results of in vitro assays employing the T24 cell line were similar to those obtained with the LS180 cell line. Hydralazine treatment markedly reduced 99m Tc-MIBI and 201 Tl accumulation in LS180 xenografts; moreover, intratumoural pO 2 decreased from 14.5±6.6 mmHg to 7.6±6.2 mmHg. 99m Tc-HL91 accumulation in xenografts was markedly increased by hydralazine. In conclusion, hypoxia reduced accumulation of 99m Tc-MIBI and 201 Tl in tumour cells. Accordingly, hypoxia may be an important factor in

Localization of ectopic parathyroid glands using technetium-99m sestamibi imaging: comparison with magnetic resonance and computed tomographic imaging

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Ishibashi, Masatoshi; Nishida, Hidemi; Hiromatsu Yuji; Kojima, Kazuyuki; Uchida, Masafumi; Hayabuvhi, Naofumi

1997-01-01

The aim of the study was to compare the accuracy of technetium-99m sestamibi imaging for localization of ectopic parathyroid glands in patients with hyperparathyroidism with that of magnetic resonance (MR) and computed tomographic (CT) imaging. Eleven patients with primary (n=3) or secondary (n=8) hyperparathyroidism were studied with 99m Tc sestamibi parathyroid imaging CT and MR imaging. Images of the neck were acquired at 10 min and 2-3 after tracer injection. The three patients with primary hyperparathyroidism and five patients with secondary hyperparathyroidism underwent parathyroidectomy. The ectopic glands were confirmed by histopathological examination of the resected specimens. In respect of 20 parathyroid glands in the eight patients explored surgically, the sensitivity and specificity of sestamibi imaging were 70% (14/20) and 88%, respectively, those of CT, 40% (8/20) and 88%, and those of MR imaging, 60% (12/20) and 88%. Of these patients, three had parathyroid adenomas while five had hyperplasia (17 glands). Sestamibi imaging localized eight ectopic parathyroid glands, which were surgically confirmed (six were located in the thymus and two in the mediastinum). In one patient explored surgically, the ectopic gland was located outside the field of the MR coil. Although the remaining three cases of secondary hyperparathyroidism were not confirmed surgically, these patients demonstrated sestamibi uptake in five parathyroid glands, including three ectopic glands. MR imagedemonstrated abnormal parathyroid glands in the same regions as sestamibi imaging. Our data indicate that 99m Tc-sestamibi imaging should be used initially to localize the ectopic parathyroid glands in patients with hyperparathyroidism for anatomical guidance prior to MR or CT imaging

Effect of collateral circulation on myocardial protection in patients with acute myocardial infarction. Comparison of technetium-99m-tetrofosmin myocardial single photon emission computed tomography and coronary angiography

International Nuclear Information System (INIS)

Yoshida, Michi; Kondo, Makoto; Abe, Yoshiteru; Kubota, Tomoyuki; Matsuoka, Ryota; Araki, Makoto; Tanio, Hitoshi; Doyama, Kiyoshi

2006-01-01

Evaluation of myocardial blood flow from collateral vessels into the infarct area has been estimated by coronary angiography. In patients with acute myocardial infarction with Thrombolysis in Myocardial Infarction (TIMI) 0 flow, myocardial tracer uptake on single photon emission computed tomography (SPECT) images can predict the collateral blood flow in the infarct area if technetium (Tc)-99m-tetrofosmin was administered before recanalization. The present study investigated whether collateral blood flow evaluated by myocardial scintigraphy is a good predictor of myocardial salvage in patients with acute myocardial infarction. The study group consisted of 30 patients (mean age 65±14 years, 23 males, 7 females) with first acute myocardial infarction and coronary angiography evidence of total occlusion (TIMI 0) within 12 hr after the onset. All patients had one vessel disease related to infarction and TIMI 3 flow after percutaneous coronary intervention (PCI). Tc-99m-tetrofosmin was injected intravenously before the PCI. The regional severity score index (RSSI) was obtained from SPECT using the 17 segment method with the four-point scoring system. Myocardial viability was evaluated by the RSSI obtained from thallium-glucose-insulin infusion SPECT after 1 week and regional wall motion score index obtained from echocardiography during the chronic phase. The patients were divided into two groups according to the angiographic collateral finding. There were no differences in RSSI on thallium-glucose-insulin SPECT and regional wall motion score between the good collateral group (n=8) and poor collateral group (n=22). Myocardial Tc-99m-tetrofosmin RSSI was similar in these groups. On the other hand, the patients were divided according to Tc-99m-tetrofosmin scintigraphic evaluation before PCI. RSSI on thallium-glucose-insulin SPECT was significantly greater (0.7±0.5 vs 1.5±0.4, p<0.01) and regional wall motion score was significantly less (1.46±0.50 vs 2.08±0.78, p<0

Tumor affinity of technetium-99m labeled radiopharmaceuticals. II. Sup(99m)Tc-Sn-diphosphonate (sup(99m)Tc-EHDP), sup(99m)Tc-Sn-dimercaptosuccinic acid (sup(99m)Tc-DMSA), sup(99m)Tc-Sn-diethyl stilbestrol diphosphate (sup(99m)Tc-DSDP)

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Itoh, K; Kobayashi, S; Hisada, K; Tonami, N [Kanazawa Univ. (Japan). School of Medicine; Ando, A

1976-10-01

The authors have examined the tumor affinity of various sup(99m)Tc-labelled radiopharmaceuticals to Ehrlich's tumor for the purpose of delineating human malignant neoplasm positively. The biologic distributions of sup(99m)Tc-Sn-diphosphonate (sup(99m)Tc-EHDP), sup(99m)Tc-Sn-dimercaptosuccinic acid (sup(99m)Tc-DMSA) and sup(99m)Tc-Sn-diethyl stilbestrol diphosphate (sup(99m)Tc-DSDP, sup(99m)Tc-Honvan) are included as the second report on the tumor affinity of Ehrlich-bearing mice. Tumor concentration of sup(99m)Tc-EHDP was lowest and the positive delineation of implanted tumor with sup(99m)Tc-EHDP was poorest in sequential images, though active accumulation in some soft tissues malignant neoplasms, breast cancer, and thyroid cancer, has been reported. Tumor concentration and the tumor-to-blood ratio of sup(99m)Tc-DMSA were not so high, contrary to our expectation that /sup 197/Hg-DMSA might show high tumor concentration and high tumor-to-blood ratio the same as /sup 197/Hg chlormerodrin of the renal scanning radiopharmaceuticals. Tumor concentration of sup(99m)Tc-DSDP was highest. The tumor-to-blood concentration ratio was lower than that of the above mentioned radiopharmaceuticals but the tumor-to-liver ratio and/or tumor-to-lung ratio was over 1.0 at the earlier time. Biologic distribution of sup(99m)Tc-DSDP was similar to that of /sup 32/P labeled DSDP. It is presumed that sup(99m)Tc is labeled at the phosphate ester of DSDP which is dephospholytated immediately by phospholylase in vivo following intravenous injection. Although it is not known precisely it may be assumed that the mechanism of accumulating sup(99m)Tc-DSDP in Ehrlich's tumor is related to the phospholylase activity in neoplasms.

The effect of collateral flow and myocardial viability on the distribution of technetium-99m sestamibi in a closed-chest model of coronary occlusion and reperfusion

International Nuclear Information System (INIS)

Chareonthaitawee, P.; O'Connor, M.K.; Gibbons, R.J.; Christian, T.F.; Ritman, E.L.

2000-01-01

The objective of this study was to determine the effect of myocardial viability and the degree of collateral blood flow on the uptake and retention of 99m Tc-sestamibi by examining three animal models of coronary occlusion and reperfusion, each reflecting a different state of viability and collateral blood flow. Three closed-chest animal models were studied: canine (high collateral flow, preserved viability), porcine (low collateral flow, absent viability) and porcine with slowly occlusive coronary stents producing infarction and enhanced collateral blood flow (high collateral flow, absent viability). There were seven dogs, seven pigs and six pigs, respectively, in each animal model. Animals from all three models were subjected to a 40-min total left anterior descending artery (LAD) occlusion followed by 2 h of reperfusion. 99m Tc-sestamibi and radiolabelled microspheres were injected during LAD occlusion 10 min prior to reperfusion. Animals were sacrificed after 2 h of reperfusion flow. Ex situ heart slice imaging to determine risk area was followed by viability staining to determine infarct size. Slices were subsequently sectioned into equally sized radial segments and placed in a gamma well counter. Risk area as determined by ex situ 99m Tc-sestamibi imaging was not significantly different by model. Pathological infarct size differed significantly by model [canine = 1%±1% of the left ventricle (LV); porcine = 13%±8% LV; porcine with stent = 14%±7% LV; P=0.002]. Collateral blood flow by microspheres during occlusion tended to differ among models (overall P=0.08), with the canine and porcine with stent models having relatively high flow rates compared with the acute porcine model. 99m Tc-sestamibi activity correlated with microsphere blood flow in all three models, with r values for individual animals (n=20) ranging from 0.86 to 0.96 (all P 99m Tc-sestamibi uptake with myocardial blood flow. 99m Tc-sestamibi uptake overestimated blood flow to a greater extent

Detection and assessment of unstable angina using myocardial perfusion imaging: Comparison between technetium-99m sestamibi SPECT and 12-lead electrocardiogram

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Gregoire, J.; Theroux, P.

1990-01-01

Forty-five studies using technetium-99m (Tc-99m) sestamibi single photon emission computed tomography (SPECT) were performed on patients hospitalized for spontaneous chest pain suggestive of myocardial ischemia. The studies were done after an injection during an episode of chest pain and a repeated injection when the patients were free of pain. All patients were hospitalized with a presumed diagnosis of unstable angina, and none had evidence of a previous myocardial infarction. The presence of a perfusion defect observed with Tc-99m sestamibi injected during chest pain had a 96% sensitivity and a 79% specificity for the detection of significant coronary artery disease (stenosis greater than or equal to 50%) on subsequent angiography. When the criterion of a larger perfusion defect during pain compared to absence of pain was used, the sensitivity was 81% and the specificity was 84%. In contrast, transient electrocardiographic ischemic changes during pain had a sensitivity of 35% and a specificity of 68%; electrocardiographic changes during or outside episodes of chest pain had a sensitivity of 65% and a specificity of 63% for the diagnosis. Tc-99m sestamibi SPECT represents a reliable noninvasive diagnostic tool that could aid in the diagnosis of myocardial ischemia in patients with spontaneous chest pain and provide additional information to that provided by the electrocardiogram

Impaired exercise-related myocardial uptake of technetium-99m-tetrofosmin in relation to coronary narrowing and diabetic state

International Nuclear Information System (INIS)

Sasao, Hisataka; Nakata, Tomoaki; Tsuchihashi, Kazufumi; Wakabayashi, Takeru; Nakahara, Norifumi; Doi, Atsushi; Hashimoto, Akiyoshi; Kobayashi, Hiroshi; Shimamoto, Kazuaki

2001-01-01

Despite the diagnostic efficacy of stress myocardial perfusion imaging, the correlation between the actual perfusion tracer activity and diseased state of a coronary artery has not been studied in detail. We estimated exercise-related perfusion augmentation in relation to disease states of a coronary artery in diabetic and non-diabetic patients by a newly developed quantitative technetium (Tc)-99m-tetrofosmin myocardial imaging technique. Tc-99m-tetrofosmin tomographic imaging with an exercise-rest protocol was performed in 26 stable coronary patients and in 8 age-matched controls. Percent increase (%IR) in myocardial count during symptom-limited submaximal exercise-stress was calculated in 16 non-infarcted polar map segments and in each coronary territory by a subtraction technique with corrections for physical decay and injected tracer doses, and the results were compared with those of angiographically quantified coronary diameter stenosis (%DS). Percent IR and peak heart rate during exercise showed a positive linear correlation both in coronary territories with significant stenosis (%DS≥75%) and in control or non-stenotic (%DS<75%) territories. The regression line in stenotic regions was, however, significantly (p<0.01) shifted downward compared to that in non-stenotic regions. Percent IR in stenotic regions showed a significant inverse correlation with %DS. Coronary stenosis of 75% or more was identified by a %IR cutoff value of 40% with 77% sensitivity, 70% specificity, and an accuracy of 72%. In coronary territories with a %DS of less than 75%, %IR in diabetic patients was significantly lower (46±15%) than that in non-diabetic patients (61±25%). Thus, blunted exercise-related augmentation of myocardial uptake of Tc-99m-tetrofosmin correlates with the severity of coronary narrowing and diabetic state. (author)

Effect of milking efficiency on Tc-99 content of Tc-99m derived from Tc-99m generators

International Nuclear Information System (INIS)

Bonnyman, J.

1983-01-01

Tc-99m obtained by separation from its parent Mo-99 always contains Tc-99 produced by decay of Tc-99m and Mo-99. Factors effecting the Tc-99/Tc-99m ratios are discussed. An HPLC method has been developed to measure the 99 TcO 4- content of sodium pertechnetate from generators with a detection limit of 0.9 ng Tc-99 for a 500 μl/ aliquot of TcO 4- -99m. First eluates of 10 chromatograph-ic generators gave Tc-99/Tc-99m ratios ranging from 3.5-46 ng Tc/mCi Tc-99m measured at the time of milking. The measurements indicate that Tc-99/Tc-99m ratios high enough to cause adverse labelling effects could be found in 'instant pertechnetate' and in the first eluate from Tc-99m generators for the activities normally used in radiopharmaceutical production

Pre-operative localization of parathyroid adenoma by Tc-99m-sestamibi scintigraphy (MIBI)

International Nuclear Information System (INIS)

Ramadan, Edward; Vishne, Tal H; Koren, Romelia; Lerner, Igor; Melloul, Moshe; Dreznik, Zeev

2002-01-01

The use of pre-operative imaging for localization of primary parathyroid adenoma may influence the duration and results of parathyroidectomy. The current study was aimed to evaluate the efficiency of localization of parathyroid adenoma by Tc-99m-sestamibi (MIBI) scintigraphy and compare the results with those achieved by the use of preoperative ultrasound. Seventy five patients, aged 25 to 83 years with primary hyperparathyroidism were operated due to primary adenoma in Rabin Medical Center from January 1995 to April 1997. Fifty of them had a preoperative MIBI scintigraphy and ultrasound for localization of parathyroid adenoma, while 25 had a preoperative ultrasound alone. Ultrasound identified correctly the adenoma in 84 percent of the cases, as compared to 96 percent identified by MIBI scintigraphy (p<0.01). MIBI scintigraphy shortened operation length from 120±20 min to 80±15 min (p<0.05) and reduced the number of frozen sections from 2.2±0.4 to 1.1±0.3 (p<0.001). MIBI scintigraphy is the most efficient modality for preoperative localization of parathyroid adenoma as compared to other imaging procedures, and can shorten operative time (Au)

Utility of Tc-99m Sestamibi scintigraphy in predicting the post-surgical recurrences in patients with osteosarcoma

International Nuclear Information System (INIS)

Racioppi, S.; Lastiri, J.; Pallotta, G.; Dibar, E.; Makiya, M.; Jager, V.; Montivero, M.; Muscolo, L.; Parysow, O.

2004-01-01

Full text: Anatomic modalities are not specific enough to evaluate local recurrences in the post-surgical follow up of patients with osteosarcoma. The purpose of this study was to assess the value of Tc-99m Sestamibi (MIBI) scans in the post-surgical follow up of patients with osteosarcoma. We analysed the results of 83 Tc-99m MIBI studies in 32 patients and compared these with other investigations like CT, MRI, X-ray, bone scans and also correlated with histopathology findings. Two independent observers evaluated all the scans. Sixteen out of 83 scans were found to be MIBI positive. Eleven of these 16 scans were confirmed as true positive (PPV 69%) and 5 false positive (FP). Scintiscans in 2 of these 5 patients were acquired early after surgery and in the long term follow up both became negative. The other 3 FP scans were labeled as pseudoarthrosis or graft fracture. Of the 67 negative scans, 64 were true negative (NPV 95%). Three were false negative, 2 of them were cases with MDR. It was concluded that MIBI whole body scan is a useful tool in the post-surgical follow up of patients with osteosarcoma, particularly to evaluate local or regional recurrences. A negative scan is highly predictive for no tumor recurrence. A negative baseline scan could be consistent with MDR gene expression. (author)

Chocolate intake may reduce liver count in 99m-Tc-tetrofosmin myocardial SPECT

International Nuclear Information System (INIS)

Tsunekawa, Akikazu; Yasuda, Eisuke; Okuda, Seiji

2005-01-01

The accumulation of 99m-Tc-Tetrofosmin (TF) in the liver and intestine may often interfere the image quality of myocardial TF SPECT. Although milk intake before acquisition is recommended to reduce its accumulation by enhancing biliary excretion of TF, some patients cannot accept milk. To elucidate the efficacy of chocolate intake as a substitute for milk, we investigated 72 patients with coronary heart disease who underwent TF SPECT (stress imaging; n=36, rest imaging; n=36). Following injection of TF, the patients were randomly treated either with milk (n=24), or chocolate (n=24). The images were acquired before treatment, at 15 min, at 30 min, and 45 min after treatment. The ratio of liver to heart count (LHR) was calculated and was compared between the two groups. LHR in the stress imaging was not significantly different between the milk-treated and chocolate-treated groups: 1.86 vs 1.87 before treatment, 1.39 vs 1.39 at 30 min, and 1.02 vs 1.03 at 45 min. LHR in the rest imaging was also the same between the two groups: 1.43 vs 1.42 before treatment, 1.22 vs 1.21 at 15 min, and 0.95 vs. 0.95 at 30 min. Chocolate intake may be equally effective to milk intake in reducing the liver accumulation of TF. (author)

Experimental studies of the physiologic properties of technetium-99m agents: Myocardial transport of perfusion imaging agents

International Nuclear Information System (INIS)

Meerdink, D.J.; Leppo, J.A.

1990-01-01

The physiologic properties of new technetium-99m-labeled myocardial imaging agents (Tc-99m sestamibi, an isonitrile; and Tc-99m teboroxime, a boronic acid adduct of technetium dioxime) are discussed and compared to thallium-201 (Tl-201). Studies with isolated hearts, subcellular fractions and cell cultures indicate that Tc-99m sestamibi, Tc-99m teboroxime and Tl-201 do not share common transport or sequestration mechanisms. Although peak Tc-99m sestamibi myocardial extraction over time is about half that of Tl-201 at equivalent coronary blood flows, the amount of Tc-99m sestamibi that remains in the heart is similar to that of Tl-201 because of its higher retention efficiency. The high retention efficiency for Tc-99m sestamibi also results in minimal redistribution. In contrast, Tc-99m teboroxime myocardial extraction is higher than that of Tl-201, but its retention is less efficient, resulting in relatively rapid washout characteristics which may quickly result in tracer redistribution. During reperfusion after a no-flow period, Tc-99m sestamibi extraction and retention increase, but for Tc-99m teboroxime and Tl-201 these values tend to decrease. All tracers show adequate transport characteristics for perfusion imaging, and differences in transport and retention should lead to the development of new clinical protocols.27 references

Technetium-99m-sestamibi scintigraphy in breast nodes; Estudo cintilografico de nodulos mamarios com tecnecio-99m-sestamibi

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Pellini, Marcos Pinto; Fonseca, Lea Mirian Barbosa da [Universidade Federal, Rio de Janeiro, RJ (Brazil). Faculdade de Medicina; Balen, Jacir Luiz; Fabricio, Maria Ines Menescal [Universidade Federal, Rio de Janeiro, RJ (Brazil). Faculdade de Medicina. Inst. de Ginecologia; Amarante Junior, Jose Luiz de Medeiros

1997-01-01

The purpose was to was to determine if technetium-99m-sestamibi accumulates preferentially within the malignant palpable nodes of breast. Twenty-five patients, mean age 36.16 ({+-} 9.34) year, and without any other additional information, underwent breast scintigraphy and excisional biopsy. We had nineteen true-negative cases, four true-positive, two false-positive and none false-negative. Sensitivity, 100% specificity, 90.5%, accuracy, 92%; PPV, 66.7%, NPV, 100%. The four true positive were invasive intraductal carcinomas and one of them metastases in auxiliary lymph-nodes, confirmed in biopsy and well defined in scintigraphy. The two false-positives were a fibroadenoma with high cellularity and a fibrodisplasy surrounded by chronic inflammatory process. Two statistical tests were applied: chi-square and Fisher. Both rejected the antithesis at a confidence interval of 99% (p , 0.01) We concluded that technetium-99-sestamibi accumulates preferentially within the malignant nodes of breast. (author) 17 refs., 3 figs., 2 tabs.

Primary breast cancer imaging with technetium-99m sestamibi and its relation with P-glycoprotein overexpression

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Moretti, J.L. [Medicine Nucleaire, CHU Bobigny, Paris (France); Azaloux, H. [Medicine Nucleaire Oncologie, Hopital P. Zobda Quitman, Fort de France (France); Boisseron, D. [Medicine Nucleaire Oncologie, Hopital P. Zobda Quitman, Fort de France (France); Kouyoumdjian, J.C. [Service de Biochemie, Hopital Henri Mondor, Creteil (France); Vilcoq, J. [Service de Cancerologie-Radiotherapie, Inst. Curie, Paris (France)

1996-08-01

The aim of this preliminary study was to evaluate retrospectively sestamibi scintigraphy in relation to the presence of the 170-kDa P-glycoprotein (Pgp), which represents an expression of multidrug resistance in patients with primary breast cancer. Fifteen women (age range 37-76 years) were referred for technetium-99m sestamibi scintigraphy because of suspicious breast lesions detected by mammography and ultrasonography, and subsequently assessed by fine-needle aspiration. Scintigraphy was performed 30 min following the injection of 500 MBq {sup 99m}Tc-sestamibi. Three planar anterior and oblique images were obtained with the patient in the supine position. Excised tumours were assessed for cytosolic CA 15.3, oestrogen (OR) and progesterone (PR) receptors and c-erb B2 neu oncogene. Pathology revealed that only 13 of the 15 patients had malignant tumours. The two benign tumours were sestamibi-negative and Pgp-positive. Sestamibi scintigraphy was positive in 10 of the 13 malignant lesions (including nine of ten infiltrating ductal carcinomas). Two of the three lesions with false-negative scintigraphy were Pgp-negative; in one of these cases histology revealed an invasive lobular carcinoma and in the other, mucinous adenocarcinoma. The third false-negative lesion was a Pgp-positive infiltrating ductal carcinoma which was c-erb B2 neu-negative but CA 15.3-, OR- and PR-positive. This preliminary study confirms that the resistance to chemotherapy which may occur in patients with primary breast cancer can be a cause of negative sestamibi scintigraphy. (orig.)

Enterogastroesophageal reflux detected on 99m-technetium sestamibi cardiac imaging as a cause of chest pain

International Nuclear Information System (INIS)

Erdogan, Zeynep; Silov, Güler; Özdal, Aysegül; Turhal, Özgül

2013-01-01

Myocardial perfusion imaging (MPI) with technetium-99m sestamibi ( 99m Tc MIBI) is considered a diagnostic technique that is widely used for the investigation of suspected coronary artery disease. Incidental inspection of an extracardiac activity is indirect, but important marker, which can identify a potentially treatable non-coronary cause for chest pain that may mimic cardiac symptoms. Here, we present an illustrative case in which significant enterogastroesophageal reflux of 99m Tc MIBI occurred during the cardiac imaging following prompt hepatobiliary clearance. Because, there was normal myocardial perfusion on MPI, presence of gastroesophageal reflux (GER) on GER scintigraphy and detection of mild inflammation with pathologically confirmed hyperplastic polyp by endoscopy, in view of the above findings we concluded that the probable cause of chest pain was reflux. (author)

Single photon emission computed tomography of technetium-99m tetrofosmin myocardial perfusion imaging in patients with systemic lupus erythematosus-A preliminary report

International Nuclear Information System (INIS)

Lin, Jen-Jhy; Hsu, Hsiu-Bao; Sun, Shung-Shung; Kao, Chia-Hung; Ho, Shung-Tai

2003-01-01

The purpose of this study was to evaluate the utility of single-photon emission computed tomography (SPECT) of technetium-99m tetrofosmin (Tc-99m TF) myocardial perfusion imaging to detect myocardial involvement in patients with systemic lupus erythematosus (SLE). Three groups of subjects-group 1: 25 SLE female patients with non-specific cardiac symptoms and signs, group 2: 25 female SLE patients without any cardiac symptoms and signs, and group 3: 25 female healthy controls-were evaluated by comparing rest and dipyridamole-stress Tc-99m TF myocardial perfusion SPECT. Tc-99m TF myocardial perfusion SPECT revealed perfusion defects in 88% and 40% of the cases in groups 1 and 2, respectively. However, no cases in group 3 demonstrated myocardial perfusion defects. Tc-99m TF myocardial perfusion SPECT is a useful noninvasive imaging modality to detect cardiac involvement in SLE patients with or without cardiac symptoms and signs. (author)

ST-segment elevation induced by ergometric stress during myocardial perfusion test with {sup 99m}Tc-SESTAMIBI; Supradesnivel ST inducido por stress ergométrico durante el estudio de perfusión miocárdica con {sup 99m}Tc-SESTAMIBI

Energy Technology Data Exchange (ETDEWEB)

Pastore, F. A.; Fernández, C. C.; Giovaneti, A.; Malvar, M.; Abud, A.C., E-mail: franciscopastore@gmail.com [Hospital Interzonal De Agudos Eva Perón, Provincia de Buenos Aires (Argentina)

2014-07-01

ST-segment elevation provoked by the exercise test is a low prevalence response. Two clinical cases in which such behavior arose during the myocardial technetium-99m-Sestamibi SPECT test are described. Physiopathological considerations in correlation with the bibliography linked to the subject are made. (authors) [Spanish] El supradesnivel del segmento ST inducido por el test de ejercicio es una respuesta de baja prevalencia. Se descri¬ben dos casos clínicos, en los cuales, dicho comporta¬miento se presentó durante el estudio de perfusión mio¬cárdica con tecnecio-99m-Sestamibi SPECT. Se realizan consideraciones fisiopatológicas en corre¬lación con los antecedentes bibliográficos vinculados al tema. (autores)

Mismatched uptake of Tc-99m-ECD and Tc-99m-HMPAO in subacute cerebral infarction: Tc-99m-ECD for viability and Tc-99m-HMPAO for flow restoration

Energy Technology Data Exchange (ETDEWEB)

Lee, D. S.; Hyun, I. Y.; Kim, S. K. [College of Medicine, Seoul National Univ., Seoul (Korea, Republic of)] [and others

1997-07-01

Tc-99m-HMPAO reflects tissue perfusion but Tc-99m-ECD uptake is affected by tissue viability in addition to tissue perfusion which the varied state of cellular retention of Tc-99m-ECD reflects. Luxuriously perfused area on Tc-99m-HMPAO SPECT implies that this cortex was already reperfused either spontaneously or after thrombolysis and that accompanied paralysis of vascular reactivity in those zones warms progressive deterioration. We tried to find out if we can use sequential Tc-99m-ECD/Tc-99m-HMPAO SPECT to reveal cortical perfusion and severity and range of risky areas of cerbral cortex despite reperfusion in sub-acute infarction. In 13 patients (M ; F =7 : 6, mean age 57 (range: 26-84)) with cortical (n=12) and basal ganglia infarction (1), we performed sequential Tc-99m-ECD/Tc-99m-HMPAO SPECT at the same position. At first, 555 MBq of Tc-99m-ECD was injected and imaged and then 1110 MBq of Tc-99m-HMPAO was injected again and imaged with the patients in situ, and the first image (Tc-99m-ECD) and the subtracted image (2nd- 1st : Tc-99m-HMPAO) were compared slice by slice. Study was done from 3 days to 31 days (16{+-}9) after ictus. Tc-99m-ECD uptake was always less than or equal to Tc-99m-HMPAO uptake at the lesion in all cases. Luxury perfusion was prominent in four patients. Mismatched uptake was found in 10 patients. Severity of mismatch showed diverse spectrum and was ranged from total middle cerebral artery territory (1 case) to peripheral thin zones around infarction (2 cases). The other 7 showed intermediate amount of tissues with mismatch , i.e., Tc-99m-ECD defects where Tc-99m-HMPAO uptake is in part increased, normal or decreased. Upon discharge, patients having more uptake with Tc-99m-ECD predicted improvement. Patients having mismatched uptake went dichotomous way. In conclusion, Tc-99m-ECD/Tc-99m-HMPAO sequential SPECT is feasible and reveal both tissue perfusion (Tc-99m-HMPAO ) and discrepant Tc-99m-ECD uptake probably reflecting viability in acute

Comparison of different modalities in diagnosis of coronary artery disease (ECG, ETT, Angiography, Rest and Stress Echo. and 99m Tc-MIBI)

International Nuclear Information System (INIS)

Zein, A.A.M.

2002-01-01

This study was conducted in order to compare the most important five investigation modalities commonly used to investigate coronary artery disease, these were ECG, Exercise Tolerance Test (ETT), Echocardiography, SPECT imaging using 99m Tc-Sestamibi, and Angiography. The three test modalities, ECG, Echo, and 99m Tc-MIBI were conducted in both rest and stress conditions. All patients were referred to the hospital (NORI) from cardiology departments of different hospitals for stress/rest 99mTc-MIBI cardiac perfusion study. The decision to proceed with coronary angiography was made by the cardiologist to confirm or exclude diagnosis of CAD, to determine the potential surgical candidates and to assess complications if any. 17 patients were included in the study, 16 males and one female. All of them underwent the five test modalities mentioned, 80% of them were smokers, 47% were hypertensives, 20% were diabetics. The sensitivity of ECG, ETT, and Echocardiography were found to be 60.0%, 73.3%, and 82.4% respectively. Both angiography and 99mTc-Sestamibi were found to be 100% sensitive for detection of CAD. Specificity for all modalities tested was found to be 1, which is unrealistically high due to the small number of normal patients (only two). The predictive value of positive test came to be 1 for all test modalities, where as the predictive value of negative test was calculated to be 0.25, 0.33, and 0.67 for the tests, ECG, ETT, and Echocardiography respectively, but in case of 99mTc-Sestamibi, and coronary angiography it was found to be 1 for both of them. The localization ability of the different test modalities for ischemic and/or infarcted areas was investigated taking coronary angiography as the gold standard. All the three modalities, ECG, Echo, and 99mTc-Sestamibi showed good results in detection of areas supplied by left anterior descending artery, and on the other hand poor results in detection of left circumflex hypoperfused tributaries. The differential

Normal LVEF measurements are significantly higher in females asassessed by post-stress resting Tc-99m sestamibi gated myocardial perfusion SPECT

International Nuclear Information System (INIS)

Kim, Jong Ho; Shin, Eak Kyun

1999-01-01

Volume-LVEF relationship is one of the most important factors of automatic EF quantification algorithm from gated myocardial perfusion SPECT(gMPS) (Germano et al. JNM, 1995). Gender difference whereby normal LVEF measurements are higher in females assessed by gMPS (Yao et al. JNM 1997). To validate true physiologic value of LVEF vs sampling or measured error, various parameters were evaluated statistically in both gender and age matched 200 subjects (mean age= 58.41±15.01) with normal LVEF more than 50%, and a low likelihood of coronary artery disease. Correlation between LVEDVi(ml/m2) and LVEF was highly significant (r=-0.62, p<0.0001) with similar correlations noted in both male (r=-0.45, p<0.0001) and female (r=-0.67, p<0.0001) subgroups. By multivariate analysis, LV volume and stroke volume was the most significant factor influencing LVEF in male and female, respectively. In conclusion, there is a significant negative correlation between LV volume and LVEF as measured by Tc-99m gated SPECT. Higher normal LVEF value should be applied to females as assessed by post-stress resting Tc-99m Sestamibi gated myocardial perfusion SPECT

DIAGNOSTIC VALUE of Tc-99m TETROFOSMİN GATED SPECT IN MYOCARDIAL VIABILITY INVESTIGATION AFTER ADMINISTRATION TRIMETAZIDINE and NITRATE IN THE PATIENTS WITH MYOCARDIAL INFARCTION

OpenAIRE

TURHAL, Özgül; TUTUŞ, Ahmet; KULA, Mustafa

2018-01-01

ABSTRACT Aim: With the aim of investigating of the myocardial viability on the patients with MI, the results obtained from Tc-99m-tetrofosmin gated SPECT following the nitrate infusion and acute TMZ were compared.Method: For this study, 30 patients who had MI and were be planned of revascularization process were taken. The patients were applied Tc-99m-tetrofosmin gated SPECT basally and following nitrate infusion and acute TMZ separately each day. The data from perfusion were quantitatively e...

99mTc labelled cationic lipophilic complexes in malignant and benign tumors: the role of SPET and pinhole-SPET in breast cancer, differentiated thyroid carcinoma and hyperparathyroidism

International Nuclear Information System (INIS)

Schillaci, O.; Spanu, A.; Madeddu, G.

2005-01-01

Single photon emission tomography (SPET) represents an indispensable diagnostic tool in nuclear medicine. Due to better contrast resolution, cross sectional and 3D images, SPET plays a useful complementary tool to bidimensional planar scintigraphy in certain clinical conditions, while representing the procedure of choice in others. However, high resolution SPET with pinhole collimator (P-SPET) can improve conventional SPET sensitivity with parallel hole collimators. This review summarized data on the employment of conventional SPET and P-SPET in breast cancer, differentiated thyroid cancer (DTC) and hyperparathyroidism patients, using the cationic lipophilic complexes ( 99m Tc )metoxy isobutyl isonitrile (sestaMIBI) and ( 99m Tc )tetrofosmin as oncotropic radiotracers. In breast cancer patients, SPET with these radiotracers can play an important complementary role to planar scintimammography in detecting primary tumors, especially when non palpable and small in size, whereas SPET and particularly P-SPET represents the procedure of choice in preoperative axillary lymph node status evaluation in which planar is almost always irrelevant. In DTC follow-up patients, SPET and P-SPET with cationic lipophilic radiotracers are indicated in both locoregional and distant metastasis detection, especially in patients with high Tg serum levels and negative radioiodine scanning in whom these procedures represent a reliable alternative to diagnostic 131 I scanning. Moreover, the combined use of ( 99m Tc)tetrofosmin P-SPET and US can identify recurrences and lymph node metastases in the neck, both fixing and non fixing iodine, down staged or negative at 131 I scanning. SPET can also be a useful complementary tool to planar parathyroid scintigraphy in the detection and localization of small and ectopic parathyroid adenomas in the neck or mediastinum, while neck P-SPET seems to also significantly increase planer sensitivity in hyperplastic glands. SPET and P-SPET are indicated in

Is Technetium-99m Sestamibi Imaging Able to Predict Pathologic Nonresponse to Neoadjuvant Chemotherapy in Breast Cancer? : A Meta-analysis Evaluating Current Use and Shortcomings

NARCIS (Netherlands)

Collarino, Angela; de Koster, Elizabeth J.; Valdés Olmos, Renato A.; de Geus-Oei, Lioe Fee; Pereira Arias-Bouda, Lenka M.

2017-01-01

Background: Interest in technetium-99m (99mTc)-sestamibi imaging for neoadjuvant chemotherapy (NAC) response monitoring in locally advanced breast cancer (LABC) is increasing but remains matter of discussion. The present study conducted a meta-analysis of the diagnostic performance of

Detecting Myocardial Ischemia With 99mTechnetium-Tetrofosmin Myocardial Perfusion Imaging in Ischemic Stroke.

Science.gov (United States)

Giannopoulos, Sotirios; Markoula, Sofia; Sioka, Chrissa; Zouroudi, Sofia; Spiliotopoulou, Maria; Naka, Katerina K; Michalis, Lampros K; Fotopoulos, Andreas; Kyritsis, Athanassios P

2017-10-01

To assess the myocardial status in patients with stroke, employing myocardial perfusion imaging (MPI) with 99m Technetium-tetrofosmin ( 99m Tc-TF)-single-photon emission computed tomography (SPECT). Fifty-two patients with ischemic stroke were subjected to 99m Tc-TF-SPECT MPI within 1 month after stroke occurrence. None of the patients had any history or symptoms of coronary artery disease or other heart disease. Myocardial perfusion imaging was evaluated visually using a 17-segment polar map. Myocardial ischemia (MIS) was defined as present when the summed stress score (SSS) was >4; MIS was defined as mild when SSS was 4 to 8, and moderate/severe with SSS ≥9. Patients with SSS >4 were compared to patients with SSS SSS >9 were compared to patients with SSS SSS, with the oldest age exhibiting the highest SSS ( P = .01). The association of age with SSS remained statistically significant in the multivariate analysis ( P = .04). The study suggested that more than half of patients with stroke without a history of cardiac disease have MIS. Although most of them have mild MIS, we suggest a thorough cardiological evaluation in this group of patients for future prevention of severe myocardial outcome.

A clinical study of gated simultaneous rest 201Tl/stress 99Tcm-sestamibi dual isotope myocardial perfusion imaging

International Nuclear Information System (INIS)

Tang Anwu; Qiao Shuixian; Luo Yaowu; Liang Xiaolin

2002-01-01

Objective: To investigate a modified gated radionuclide myocardial tomography in methodology for raising the sensitivity and efficiency of detecting myocardial ischemia. Methods: One hundred and three patients were involved and divided into two groups: coronary artery disease (CAD) patient 37, non-CAD patient 66. 201 Tl 111 MBq was injected intravenously 5 min before stress, the patient exercised with ergometer following the modified Bruce protocol, and was injected 99 Tc m -sestamibi at the peak of stress. 45 min later, the simultaneous dual energy peak gated acquisition was then performed. Stress ( 99 Tc m -sestamibi) and rest ( 201 Tl) images were reconstructed. Results: Positive findings were seen in 35/37 (94.6%) in CAD group and 7/66 (10.6%) in non-CAD, respectively; LVEF, EDV and ESV of two groups were (52.33+-16.26)%, (70.45+-28.12) mL, (33.35 +- 18.86) mL and (61.76 +- 9.38)%, (60.45 +- 18.18) mL, (23.30 +- 11.09) mL, respectively. Conclusion: The simultaneous stress ( 99 Tc m -sestamibi) and rest ( 201 Tl) gated myocardial imaging is an efficient and practical protocol for the study of myocardial perfusion and the diagnosis of ischemia

Evaluation of the absorbed dose to the kidneys due to Tc99m (DTPA) / Tc99m (Mag3) and Tc99m (Dmsa)

International Nuclear Information System (INIS)

Vasquez A, M.; Murillo C, F.; Castillo D, C.; Rocha J, J.; Sifuentes D, Y.; Sanchez S, P.; Idrogo C, J.; Marquez P, F.

2015-10-01

The absorbed dose in the kidneys of adult patients has been assessed using the biokinetics of radiopharmaceuticals containing Tc 99m (DTPA) / Tc 99m (Mag3) or Tc 99m (Dmsa).The absorbed dose was calculated using the formalism MIRD and the Cristy-Eckerman representation for the kidneys. The absorbed dose to the kidneys due to Tc 99m (DTPA) / Tc 99m (Mag3), are given by 0.00466 mGy.MBq -1 / 0.00339 mGy.MBq -1 . Approximately 21.2% of the absorbed dose is due to the bladder (content) and the remaining tissue, included in biokinetics of Tc 99m (DTPA) / Tc 99m (Mag3). The absorbed dose to the kidneys due to Tc 99m (Dmsa) is 0.17881 mGy.MBq -1 . Here, 1.7% of the absorbed dose is due to the bladder, spleen, liver and the remaining tissue, included in biokinetics of Tc 99m (Dmsa). (Author)

Limitations of Tc99m-MIBI-SPECT imaging scans in persistent primary hyperparathyroidism.

Science.gov (United States)

Witteveen, Janneke E; Kievit, Job; Stokkel, Marcel P M; Morreau, Hans; Romijn, Johannes A; Hamdy, Neveen A T

2011-01-01

In primary hyperparathyroidism (PHPT) the predictive value of technetium 99m sestamibi single emission computed tomography (Tc99m-MIBI-SPECT) for localizing pathological parathyroid glands before a first parathyroidectomy (PTx) is 83-100%. Data are scarce in patients undergoing reoperative parathyroidectomy for persistent hyperparathyroidism. The aim of the present study was to determine the value of Tc99m-MIBI-SPECT in localizing residual hyperactive parathyroid tissue in patients with persistent primary hyperparathyroidism (PHPT) after initial excision of one or more pathological glands. We retrospectively evaluated the localizing accuracy of Tc99m-MIBI-SPECT scans in 19 consecutive patients with persistent PHPT who had a scan before reoperative parathyroidectomy. We used as controls 23 patients with sporadic PHPT who had a scan before initial surgery. In patients with persistent PHPT, Tc99m-MIBI-SPECT accurately localized a pathological parathyroid gland in 33% of cases before reoperative parathyroidectomy, compared to 61% before first PTx for sporadic PHPT. The Tc99m-MIBI-SPECT scan accurately localized intra-thyroidal glands in 2 of 7 cases and a mediastinal gland in 1 of 3 cases either before initial or reoperative parathyroidectomy. Our data suggest that the accuracy of Tc99m-MIBI-SPECT in localizing residual hyperactive glands is significantly lower before reoperative parathyroidectomy for persistent PHPT than before initial surgery for sporadic PHPT. These findings should be taken in consideration in the preoperative workup of patients with persistent primary hyperparathyroidism.

Assessment of response of limb sarcoma to neoadjuant chemotherapy with Tc99m SESTAMIBI

International Nuclear Information System (INIS)

Krishnakumar, R.; Priyadarshini, R.; Begum, Balkis; Manivannan, K.; Shanmugasundaram, B.; Anuradha, S.

2004-01-01

Full text: Osteosarcoma is one of the malignant tumours, which spreads locally by breaking the periosteum. With the introduction of cytotoxic drugs as neo-adjuant chemotherapy, aggressive mutilating surgeries have decreased. CT/MRI though very useful in assessing the local response, nuclear medicine imaging procedures are reported to be more specific. Sestamibi, a myocardial perfusion-scanning agent also concentrates in tumours. The study is aimed at the evaluation of MIBI (Cardiolite) imaging in assessing the response of neo-adjuant chemotherapy in limb sarcomas (both bone and soft tissue tumours) before conservative resection. About 25-30 mCi of 99mTc MIBI is given intravenously followed by dynamic images for 1-2 minutes and thereafter static images at 30min., 1 hr. and 2 hours of injection. 62 patients (Osteosarcoma -35, Ewing's sarcoma -15, Rhabdomyosarcoma -1 and Soft Tissue sarcoma -1) were studied. 17 patients were dropped from the study as they progressed locally or developed metastases. Of the 35 patients having osteosarcoma, 30 patients were eligible for limb salvage surgery (LSS). 5 patients progressed locally and were not eligible for LSS and were advised amputation. Of the 10 Ewing's sarcoma patients, 7 were treated with chemotherapy, 2 underwent LSS and 1 was amputated. All these patients underwent 4 studies: 1st - baseline; 2nd- after 3 courses of chemo; 3rd - after 6 courses of chemo; 4th-after 12 cycles of chemotherapy. There were no demonstrable abnormal focal concentrations in the abdomen or elsewhere in any of these patients suggestive of metastases. The tumour site showed avid uptake. Quantitative estimation of the uptake was done. The ratios of uptake in the tumor site to the corresponding uninvolved site were calculated at different intervals viz. 5 min, 30min, 60min, 90min and 2hrs. The wash off rates of the tracer from the tumour sites at different interval was also analysed. We noticed that in patients where the ratio in the 1st and 2nd

Determination of 99Mo contamination in a nuclear medicine patient submitted to a diagnostic procedure with 99mTc

Directory of Open Access Journals (Sweden)

Bernardo Maranhão Dantas

2005-10-01

Full Text Available 99mTc is a radionuclide widely used for imaging diagnosis in nuclear medicine. In Brazil it is obtained by elution from 99Mo-99mTc generators supplied by the Nuclear Energy Research Institute (IPEN. The elution is carried out in radiopharmacy laboratories located in hospitals and clinics. Depending of the quality of the generator and conditions of use during the elution process, 99Mo can be extracted from the column of the generator, becoming a radionuclidic impurity of the eluate used for the obtention of the radiopharmaceutical to be administered to the patient. 99Mo emits high-energy photons and beta particles and its presence degrades the quality of the image and unnecessarily increases the radiation dose delivered to the patient. An in-vivo measurement technique was developed to verify the occurrence of internal contamination by 99Mo in nuclear medicine patients. Direct measurements were made in a volunteer who underwent myocardial scintigraphy with 99mTc-sestamibi. The results indicated the presence of internal contamination of the patien by 99Mot. The activity was tracked for several days, and an assessment of the radiation dose from the contaminant 99Mo was made.O 99mTc é um radionuclídeo largamente utilizado em diagnósticos por imagem em medicina nuclear. No Brasil, ele é obtido por eluição de um gerador de 99Mo-99mTc fornecido pelo IPEN. A eluição do gerador é feita nas clínicas onde se realizam os exames. Durante a eluição o 99Mo pode ser carreado da coluna, tornando-se uma impureza radionuclídica do eluato a ser utilizado para a obtenção do radiofármaco administrado ao paciente. O 99Mo emite fótons de alta energia e partículas beta, e sua presença, além de provocar degradação na qualidade da imagem do exame, aumenta desnecessariamente a dose de radiação no paciente. Assim, com o objetivo de verificar a possível ocorrência de contaminação interna por 99Mo em pacientes de medicina nuclear, foi desenvolvida

99mTc-EDTA and 99mTc-DTPA complexes as hydrological tracers

International Nuclear Information System (INIS)

Dominguez, J.; Borroto, J.; Nazco, J.; Perez, E.; Gamboa, R.; Cruz, J.

2002-01-01

The [ 99m Tc-DTPA] 2- and [ 99m Tc-EDTA] 1- were evaluated as radiotracers for short time hydrological studies. Their complex stability after labelling with 9.25 GBq of 99m Tc, the behaviour against pH variations, from 5 to 9, in simulated solutions and in natural river waters and the sorption of these compounds on the river sediments, were tested in laboratory experiments. Finally field double tracing experiments were carried out for each of labelling complexes and Rhodamine WT. From recovery calculations not losses of the 99m Tc activity were observed. The shape of the RTD curves of the [ 99m Tc-DTPA] 2- and [ 99m Tc-EDTA] 1 were quite similar to the Rhodamine Wt ones. May be concluded that both complexes behaved conservatively on the studied environmental conditions. (author)

Comparative assessment of 18F-fluorodeoxyglucose PET and 99mTc-tetrofosmin SPECT for the prediction of functional recovery in patients with reperfused acute myocardial infarction

International Nuclear Information System (INIS)

Shirasaki, Haruhisa; Nakano, Akira; Uzui, Hiroyasu; Ueda, Takanori; Lee, Jong-Dae; Yonekura, Yoshiharu; Okazawa, Hidehiko

2006-01-01

Purpose: Although preserved glucose metabolism is considered to be a marker of myocardial viability in the chronic stage, it has not been fully elucidated whether this is also true with regard to reperfused acute myocardial infarction (AMI). The aim of this study was to compare the diagnostic performance of 99m Tc-tetrofosmin SPECT and 18 F-fluorodeoxyglucose (FDG) PET for the prediction of functional recovery in reperfused AMI.Methods: The study population comprised 28 patients. Both tetrofosmin SPECT and FDG PET were performed in all 28 patients at ca. 2 weeks and in 23 at 6 months. The tetrofosmin and FDG findings in infarct-related segments were compared with the regional wall motion score assessed by left ventriculography over 6 months to determine the predictive value for functional recovery. Of 120 infarct-related segments, 83 had preserved flow (tetrofosmin uptake ≥50%) and 81 had preserved glucose metabolism (FDG uptake ≥40%). The sensitivity and specificity of tetrofosmin SPECT for the prediction of functional recovery tended to be superior to those of FDG PET (90.0% and 72.5% vs 85.0% and 67.5%, respectively). Thirteen segments with preserved flow and decreased glucose metabolism demonstrated marked recovery of contractile function from 2.5±1.0 to 1.4±1.4 (p<0.01), with restoration of glucose metabolism at 6 months. In contrast, 11 segments with decreased flow and preserved glucose metabolism demonstrated incomplete functional improvement from 3.0±0.8 to 2.2±1.2. In the subacute phase, preserved myocardial blood flow is more reliable than glucose metabolism in predicting functional recovery in reperfused myocardium. (orig.)

Evaluation of the absorbed dose to the kidneys due to Tc{sup 99m} (DTPA) / Tc{sup 99m} (Mag3) and Tc{sup 99m} (Dmsa); Evaluacion de la dosis absorbida en los rinones debido al Tc{sup 99m} (DTPA) / Tc{sup 99m} (MAG3) y Tc{sup 99m} (DMSA)

Energy Technology Data Exchange (ETDEWEB)

Vasquez A, M.; Murillo C, F.; Castillo D, C.; Rocha J, J.; Sifuentes D, Y.; Sanchez S, P. [Universidad Nacional de Trujillo, Av. Juan Pablo II s/n, Trujillo (Peru); Idrogo C, J.; Marquez P, F., E-mail: marvva@hotmail.com [Instituto Nacional de Enfermedades Neoplasicas, Av. Angamos 2520, Lima (Peru)

2015-10-15

The absorbed dose in the kidneys of adult patients has been assessed using the biokinetics of radiopharmaceuticals containing Tc{sup 99m} (DTPA) / Tc{sup 99m} (Mag3) or Tc{sup 99m} (Dmsa).The absorbed dose was calculated using the formalism MIRD and the Cristy-Eckerman representation for the kidneys. The absorbed dose to the kidneys due to Tc{sup 99m} (DTPA) / Tc{sup 99m} (Mag3), are given by 0.00466 mGy.MBq{sup -1} / 0.00339 mGy.MBq{sup -1}. Approximately 21.2% of the absorbed dose is due to the bladder (content) and the remaining tissue, included in biokinetics of Tc{sup 99m} (DTPA) / Tc{sup 99m} (Mag3). The absorbed dose to the kidneys due to Tc{sup 99m} (Dmsa) is 0.17881 mGy.MBq{sup -1}. Here, 1.7% of the absorbed dose is due to the bladder, spleen, liver and the remaining tissue, included in biokinetics of Tc{sup 99m} (Dmsa). (Author)

Improved detection of fill-in using sublingual nitroglycerin in technetium-99m tetrofosmin exercise/rest single photon emission computed tomography one day protocol for old myocardial infarction

International Nuclear Information System (INIS)

Miyanaga, Hajime; Kunieda, Yasufumi; Oguni, Atsuhiko; Kamitani, Tadaaki; Kawasaki, Shingo; Takahashi, Toru

1999-01-01

Twenty-one patients with old myocardial infarction underwent repeated 99m Tc-tetrofosmin ( 99m Tc) exercise/rest same day protocols with and without the administration of sublingual nitroglycerin (NTG) 5 min before the second injection of 99m Tc for rest SPECT. Twelve of these patients also underwent ordinary exercise/redistribution 201 Tl SPECT. The control study protocol images showed decreased uptake of 99m Tc on exercise in 157 of 420 segments and the presence of fill-in at rest in 58 segments. Images obtained with administration of NTG showed decreased uptake of 99m Tc on exercise in 163 of 420 segments and fill-in in 74 segments at rest. The frequency of fill-in was greater in the NTG protocol than in the control protocol. The segments were scored as different grades according to 99m Tc uptake between 2 protocols. Fill-in was only present or more remarkable in 31 segments in the NTG protocol than in the control protocol. Fill-in was only present or more remarkable in 10 segments in the control protocol than in the NTG protocol. In the NTG protocol, the mean defect score of the exercise images, calculated from the bull's eye image automatically, was higher than that of the rest images. The mean severity score of the exercise images, also calculated from the bull's eye image automatically, was likewise higher than that of the rest images, whereas the mean severity score of the stress images and rest images in the control protocol was not significantly different. Moreover, the mean defect score and severity score of the rest images from the NTG protocol were significantly lower than those obtained from the control protocol. Sublingual NTG administration before the injection of 99m Tc-tetrofosmin at the rest study in the one day exercise/rest studies enhanced fill-in, so may enhance the detection of viable myocardium, allowing more informed decisions regarding cardiac revascularization in patients with chronic coronary artery disease. (K.H.)

An alternative method for rapid preparation of 99Tcm-sestamibi

International Nuclear Information System (INIS)

Wilson, M.E.; Hung, J.C.; Gibbons, R.J.

1993-01-01

The availability of 99 Tc m -sestamibi is limited, especially in emergency cases due to the time-consuming preparation procedure that requires a 10-min boiling water bath and a 30-min radiochemical purity (RCP) analysis. These two restrictions have been surmounted by the combined use of a microwave oven heating method and a minipaper chromatography system. However, use of the microwave oven heating method presents some potential problems: (1) technical error in setting the microwave oven heating time and power setting; (2) ejection of the rubber septum if the vial is not evacuated; (3) breakage of the vial during the microwave heating process; (4) inconsistent and inhomogeneous microwave heating; (5) re-evaluation process required for use of a different type of microwave oven. Although a 1-min boiling water bath time is sufficient to provide an acceptable RCP for 99 Tc m -sestamibi, additional time is required to heat the water to a boiling state. An instant hot water machine was evaluated for possible replacement of the microwave heating method. Three millilitres of 5500 MBq (150 mCi) 99 Tc m was added to a Cardiolite R kit and then placed in a 150-ml insulated beaker filled with hot water from an instant hot water machine. A minipaper chromatography system was used to determine the RCP of samples after 1, 1.5, 2, 3, 4 and 5 min incubation periods. Our results show that 2 min was the shortest incubation time that yielded an acceptable RCP of 94.7 ± 0.4% over the 24 h evaluation time. (author)

Comparison of thallium-201 scan and Tc-99m sestamibi scan in the differential diagnosis of breast mass

Energy Technology Data Exchange (ETDEWEB)

Cho, Ihn Ho; Won, Kyu Jang; Lee, Hyung Woo; Lee, Soon Jung [College of Medicine, Yonsei Univ., Seoul (Korea, Republic of)

1999-02-01

We performed this study to compare Tl-201 and Tc-99m MIBI scans for the differentiation of malignant from benign breast mass. Thirty-eight female patients underwent Tl-201 breast scan and thirty-two of them also underwent Tc-99m MIBI scan of the breast. After intravenous injection of 74-111 MBq of Tl-201, early (10 minutes) and delayed (3 hours) images were obtained. Then, 555-740 MBq of Tc-99m MIBI was injected and images after 30 minutes were obtained. We compared Tl-201 and Tc-99m MIBI scans with pathologic results. Twenty-three patients were confirmed to have infiltrating duct carcinoma and fifteen patients to have benign breast mass by excisonal biopsy. The sensitivity of early and delayed Tl-201 scan and Tc-99m MIBI scan in the detection of malignant breast lesion were 100% (23/23), 82% (18/22), and 90% (18/20), respectively. The sensitivity of early Tl-201 scan was significantly higher than that of delayed Tl-201 scan, (p<0.05). The specificity of early and delayed Tl-201 scan and Tc-99m MIBI scan were 73% (11/15), 73% (11/15) and 83% (10/12), respectively (p: not significant). Three patients out of nine with fibroadenoma and one patient with atypical duct hyperplasia were false positive in both early and delayed Tl-201 scans. The size of fibroadenoma with false positive in early and delayed Tl-201 scan (4 cases) was larger than that of 11 fibroadenoma with true negative scan (p<0.01). Metastatic axillary lymph node involvement was present in fifteen patients. The sensitivity to detect metastatic nodes was 38% (5/13) for early Tl-201 images, 15% (2/13) for delayed Tl-201 images, 58% (7/12) for Tc-99m MIBI planar images and 67% (4/6) for Tc-99m MIBI SPECT. The sensitivity of Tc-99m MIBI planar or SPECT was significantly higher than that of delayed Tl-201 images (p<0.05). Early Tl-201 and Tc-99m MIBI scan are useful noninvasive methods to differentiate malignant from benign mass of breast. Tc-99m MIBI scan was sensitive in detecting axillary lymph node

Targeting osteomyelitis with complete [99mTc]besilesomab and fragmented [99mTc]sulesomab antibodies: kinetic evaluations

International Nuclear Information System (INIS)

GRATZ, Stefan; KEMKE, Bendix; KEIZE, Patrik; KAMPEN, Wim U.; LUSTER, Markus; HÖFFKEN, Helmut

2016-01-01

The aim of this retrospective study was to compare the targeting of “pure” osteomyelitis (i.e., without surrounding soft tissue infection) by directly 99mTc-labelled complete immunoglobulin G (IgG) monoclonal antibody (MAb) ([99mTc]besilesomab) and by directly 99mTc-labelled fragment antigen-binding (FAb) MAb ([99mTc]sulesomab) in relation to their kinetic fate. A total of 73 patients with “pure” osteomyelitis were examined with [99mTc]besilesomab, (Scintimun®, IBA/CIS bio international, Saclay, France; N.=38) and [99mTc]sulesomab (LeukoScan®, Immunomedics Inc., Morris Plains, NJ, USA; N.=35). Kinetic data were deduced from whole-body and single-photon emission computed tomographic scans, performed 10 minutes to 24 hour p.i. (region-of-interest technique [ROI]). In targeting “pure” osteomyelitis, sensitivities at 1-4 hours were found to be higher for [99mTc]sulesomab (44% and 80% for [99mTc]besilesomab and [99mTc]sulesomab, respectively) but at significantly lower target/background (T/B) ratios than with [99mTc]besilesomab (1.8±0.3 versus 1.4±0.5 for [99mTc]besilesomab and [99mTc]sulesomab respectively; P<0.01). With [99mTc]besilesomab, there was a continuous osteomyelitis uptake over 24 hours, whereas with [99mTc]sulesomab, the maximal uptake occurred mostly within 1-4 hours, with subsequent clearance being slower for antigen-bound activity than for nonspecific background. Hence, diagnosis was possible mostly after 4h with [99mTc]sulesomab but often not before 24 hours with [99mTc]besilesomab, the later increasing significantly (P<0.01) in sensitivity (87% and 84% for [99mTc]besilesomab and [99mTc]sulesomab, respectively). These results show that the higher sensitivity of [99mTc]sulesomab in osteomyelitis targeting at earlier p.i. times does not rely on an increased antibody uptake but on a more rapid clearance of nonspecific background activity due to faster metabolism and excretion. Intact [99mTc]besilesomab show a slow, continuous uptake

99mTc-sestamibi scintimammographic evaluation of the mammae for carcinoma

International Nuclear Information System (INIS)

Karusseit, V.O.L.; Dreyer, L.; Meyer, B.J.

2004-01-01

Full text: Introduction: The value of 99m Tc-sestamibi (MIBI) in the detection of breast carcinoma has been reported extensively, but the extent to which it might complement conventional mammography demands more studies. Although an excellent diagnostic intervention, the sensitivity of mammography decreases to less than 70% in women with radiologically dense breast tissue. The sensitivity of scintimammography, unlike standard screening modalities, is not compromised by inherent breast density. The incidence of breast cancer varies significantly among racial/ethnic groups and apparently Negroid women have higher blood estrogen levels than their Caucasian counterparts. Considering the racial, cultural and socio-economic differences of the South African population, as well as the relative simple technology and cost effectiveness of MIBI scintimammography, the question is: should scintimammography not play a more prominent role as rule-out diagnostic protocol in the evaluation of the breasts for carcinoma? Materials and methodology: Fifty-three consecutive patients presenting to the surgical out-patient department with or without breast nodules but high risk category for breast carcinoma have been recruited. After taking a history and performing a physical examination patients were referred for scintimammography and some of the patients were also referred for radiological mammography. Fine needle aspiration (FNA) was performed on all the lesions. Results: Clinical evaluation: sensitivity: 88,89%; specificity: 88.64%; false +ve: 4; false -ve :1. Sonographic evaluation: sensitivity: 100%; specificity: 33.35%; false +ve: 4; false -ve :0. MIBI scintimammography evaluation: sensitivity: 90.91%; specificity: 90,48%; false +ve: 4; false -ve: 1. Mammographic evaluation: sensitivity: 100%; specificity: 45,5%; false +ve: 6; false -ve: O. Fine needle aspiration cytology: sensitivity: 100%; specificity: 95,35%; false +ve: 2; false -ve: 1. Conclusion: Interesting as the results may

Comparison of relative renal function measured with either 99m Tc-DTPA or 99m Tc-EC dynamic scintigraphies with that measured with 99m Tc-DMSA static scintigraphy

Energy Technology Data Exchange (ETDEWEB)

Domingues, F.C.; Fujikawa, G.Y.; Decker, H.; Alonso, G.; Pereira, J.C.; Duarte, P.S. [Centro de Diagnostico Fleury, Sao Paulo, SP (Brazil). Secao de Medicina Nuclear; Sao Paulo Univ. (USP), SP (Brazil). Escola de Saude Publica. Dept. de Epidemiologia]. E-mail: paulo.duarte@fleury.com.br

2006-07-15

Objective: The aim of this study was to compare the renal function measured with either {sup 99m}Tc-DTPA or {sup 99m}Tc-EC dynamic scintigraphies with that measured using {sup 99m}Tc-DMSA static scintigraphy. Methods: the values of relative renal function measured in 111 renal dynamic scintigraphies performed either with {sup 99m}Tc-DTPA (55 studies) or with {sup 99m}Tc-EC (56 studies) were compared with the relative function measured using {sup 99m}Tc-DMSA static scintigraphy performed within a 1-month period. The comparisons were performed using Wilcoxon signed rank test. The number of {sup 99m}Tc-DTPA and {sup 99m}Tc-EC studies that presented relative renal function different by more than 5% from that measured with {sup 99m}Tc-DMSA, using chi square test were also compared. Results: the relative renal function measured with {sup 99m}Tc-EC is not statistically different from that measured with {sup 99m}Tc-DMSA (p = 0.97). The relative renal function measured with {sup 99m}Tc-DTPA was statistically different from that measured using {sup 99m}Tc-DMSA, but with a borderline statistical significance (p = 0.05). The number of studies with relative renal function different by more than 5% from that measured with {sup 99m}Tc-DMSA is higher for the {sup 99m}Tc-DTPA scintigraphy (p 0.04) than for {sup 99m}Tc-EC. Conclusion: the relative renal function measured with {sup 99m}Tc-EC dynamic scintigraphy is comparable with that measured with {sup 99m}Tc-DMSA static scintigraphy, while the relative renal function measured with {sup 99m}Tc-DTPA dynamic scintigraphy presents a significant statistical difference from that measured with {sup 99m}Tc-DMSA static scintigraphy. (author)

Comparison of relative renal function measured with either 99m Tc-DTPA or 99m Tc-EC dynamic scintigraphies with that measured with 99m Tc-DMSA static scintigraphy

International Nuclear Information System (INIS)

Domingues, F.C.; Fujikawa, G.Y.; Decker, H.; Alonso, G.; Pereira, J.C.; Duarte, P.S.; Sao Paulo Univ.

2006-01-01

Objective: The aim of this study was to compare the renal function measured with either 99m Tc-DTPA or 99m Tc-EC dynamic scintigraphies with that measured using 99m Tc-DMSA static scintigraphy. Methods: the values of relative renal function measured in 111 renal dynamic scintigraphies performed either with 99m Tc-DTPA (55 studies) or with 99m Tc-EC (56 studies) were compared with the relative function measured using 99m Tc-DMSA static scintigraphy performed within a 1-month period. The comparisons were performed using Wilcoxon signed rank test. The number of 99m Tc-DTPA and 99m Tc-EC studies that presented relative renal function different by more than 5% from that measured with 99m Tc-DMSA, using chi square test were also compared. Results: the relative renal function measured with 99m Tc-EC is not statistically different from that measured with 99m Tc-DMSA (p = 0.97). The relative renal function measured with 99m Tc-DTPA was statistically different from that measured using 99m Tc-DMSA, but with a borderline statistical significance (p = 0.05). The number of studies with relative renal function different by more than 5% from that measured with 99m Tc-DMSA is higher for the 99m Tc-DTPA scintigraphy (p 0.04) than for 99m Tc-EC. Conclusion: the relative renal function measured with 99m Tc-EC dynamic scintigraphy is comparable with that measured with 99m Tc-DMSA static scintigraphy, while the relative renal function measured with 99m Tc-DTPA dynamic scintigraphy presents a significant statistical difference from that measured with 99m Tc-DMSA static scintigraphy. (author)

Preparation and biological profile of 99mTc-lidocaine as a cardioselective imaging agent using 99mTc eluted from 99Mo/99mTc generator based on Al-Mo gel

International Nuclear Information System (INIS)

Sakr, T.M.; October University of Modern Sciences and Arts; Ibrahim, A.B.; Rashed, H.M.; Fasih, T.W.

2017-01-01

The current study is aimed to prepare 99m Tc-lidocaine as a new myocardial perfusion-imaging agent. The used 99m Tc was obtained from Al- 99 Mo-molybdate(VI) gel matrix. 99m Tc-lidocaine showed higher (15.4 ± 0.11% ID/g) and faster (15 min post injection) cardiac uptake than the recently studied 99m Tc-valsartan and 99m Tc-procainamide. Consequently, 99m Tc-lidocaine will be a valuable myocardial SPECT agent for diagnosis of emergency patients. Besides, the receptor affinity study confirmed the selectivity of 99m Tc-lidocaine for sodium channels in the heart. (author)

In-house cyclotron production of high-purity Tc-99m and Tc-99m radiopharmaceuticals.

Science.gov (United States)

Martini, Petra; Boschi, Alessandra; Cicoria, Gianfranco; Zagni, Federico; Corazza, Andrea; Uccelli, Licia; Pasquali, Micòl; Pupillo, Gaia; Marengo, Mario; Loriggiola, Massimo; Skliarova, Hanna; Mou, Liliana; Cisternino, Sara; Carturan, Sara; Melendez-Alafort, Laura; Uzunov, Nikolay M; Bello, Michele; Alvarez, Carlos Rossi; Esposito, Juan; Duatti, Adriano

2018-05-30

In the last years, the technology for producing the important medical radionuclide technetium-99m by cyclotrons has become sufficiently mature to justify its introduction as an alternative source of the starting precursor [ 99m Tc][TcO 4 ] - ubiquitously employed for the production of 99m Tc-radiopharmaceuticals in hospitals. These technologies make use almost exclusively of the nuclear reaction 100 Mo(p,2n) 99m Tc that allows direct production of Tc-99m. In this study, it is conjectured that this alternative production route will not replace the current supply chain based on the distribution of 99 Mo/ 99m Tc generators, but could become a convenient emergency source of Tc-99m only for in-house hospitals equipped with a conventional, low-energy, medical cyclotron. On this ground, an outline of the essential steps that should be implemented for setting up a hospital radiopharmacy aimed at the occasional production of Tc-99m by a small cyclotron is discussed. These include (1) target production, (2) irradiation conditions, (3) separation/purification procedures, (4) terminal sterilization, (5) quality control, and (6) Mo-100 recovery. To address these issues, a comprehensive technology for cyclotron-production of Tc-99m, developed at the Legnaro National Laboratories of the Italian National Institute of Nuclear Physics (LNL-INFN), will be used as a reference example. Copyright © 2018 Elsevier Ltd. All rights reserved.

Altered [99mTc]Tc-MDP biodistribution from neutron activation sourced 99Mo.

Science.gov (United States)

Demeter, Sandor; Szweda, Roman; Patterson, Judy; Grigoryan, Marine

2018-01-01

Given potential worldwide shortages of fission sourced 99 Mo/ 99m Tc medical isotopes there is increasing interest in alternate production strategies. A neutron activated 99 Mo source was utilized in a single center phase III open label study comparing 99m Tc, as 99m Tc Methylene Diphosphonate ([ 99m Tc]Tc-MDP), obtained from solvent generator separation of neutron activation produced 99 Mo, versus nuclear reactor produced 99 Mo (e.g., fission sourced) in oncology patients for which an [ 99m Tc]Tc-MDP bone scan would normally have been indicated. Despite the investigational [ 99m Tc]Tc-MDP passing all standard, and above standard of care, quality assurance tests, which would normally be sufficient to allow human administration, there was altered biodistribution which could lead to erroneous clinical interpretation. The cause of the altered biodistribution remains unknown and requires further research.

Use of 99mTc from a commercial 99Mo/9mTc generator as yield tracer for the determination of 99Tc at low levels

DEFF Research Database (Denmark)

Hou, Xiaolin; Jensen, Mikael; Nielsen, Sven Poul

2007-01-01

The concentrations of Tc-99 and impurity radionuclides in the Tc-99m tracer solution obtained from a commercial Mo-99/Tc-99m generator were measured by gamma spectrometry and liquid scintillation counting. Mo-99 and Ru-103 were found in the Tc-99m eluate. A simple separation using two extra alumina...... cartridges was investigated to purify the eluate to obtain a suitable Tc-99m tracer with low Tc-99 concentration. The activity ratio of Tc-99/Tc-99m in the prepared Tc-99m solution is lower than 15 x 10(-9), which is higher than the theoretical ratio of less than 10 x 10(-9). The possible reason is discussed....... The Tc-99 in the 20 kBq spiked Tc-99m tracer was found to be less than 0.3mBq, which is lower than the detection limit of the radiometric method used for environmental samples. The purified Tc-99m eluate is used as yield tracer for the determination of low levels of Tc-99 in environmental samples. (c...

Clinical application of 99Tcm-tetrofosmin in diagnosis patients with coronary heart disease

International Nuclear Information System (INIS)

Li Na; Chen Song; Wang Xiaobei; Wang Ying; Yin Yafu; Li Xuena; Li Yaming; Wang Lijuan; He Zuoxiang

2012-01-01

Objective: To evaluate the diagnostic value of 99 Tc m -tetrofosmin(TF) stress-rest MPI in detecting CHD. Methods: Eighty patients with suspected CHD who had stress-rest MPI from October 2009 to April 2011 were retrospectively analyzed.Forty underwent 99 Tc m -TF (group A) and 40 received 99 Tc m -MIBI (group B) stress-rest MPI. Heart/lung (H/L) ratios of these two groups were compared.CAG was performed on group A patients 3 months before and after MPI. Stenosis of more than 50% in CAG was used as a standard to evaluate the diagnostic efficiency of 99 Tc m -TF MPI. Paired t test and χ 2 test were used to compare the data. Results: H/L ratios of rest and stress from 99 Tc m -TF images were 6.73 ± 1.21 and 6.94 ± 1.69, while those from 99 Tc m -MIBI images were 6.58 ± 1.94 and 6.64 ± 1.81, respectively. There was no difference between 99 Tc m -TF and 99 Tc m -MIBI imaging in both rest and stress (t=0.41, 0.78, both P>0.05). There was no difference between H/L ratios from stress and rest 99 Tc m -TF imaging (t=0.69, P >0.05). Twenty-four patients who underwent 99 Tc m -TF imaging had abnormal perfusion (60.0%, 24/40), including 20 LAD, 11 LCX and 14 RCA. Twenty-three among these 40 patients had abnormal CAG results (57.5%, 23/40), including 19 LAD, 12 LCX, and 11 RCA. The sensitivity, specificity, accuracy, positive predictive value and negative predictive value of 99 Tc m -TF stress-rest MPI were 87.0% (20/23), 76.5% (13/17), 82.5% (33/40), 83.3% (20/24) and 81.2% (13/16), respectively. The sensitivities of 99 Tc m -TF stress-rest MPI for detection of LAD, LCX and RCA were 89.5% (17/19), 83.3% (10/12) and 90.9% (10/11), respectively,and positive predictive values were 85.0% (17/20), 90.9% (10/11) and 71.4% (10/14), respectively. There was no significant difference for sensitivity and positive predictive value of 99 Tc m -TF MPI among different vessels (χ 2 =0.377 and 1.789, both P>0.05). Conclusions: 99 Tc m -TF MPI has comparative imaging quality to 99 Tc m

Preoperative radiological diagnosis by 99mTc·MIBI-99mTc subtraction scintigraphy for primary hyperparathyroidism

International Nuclear Information System (INIS)

Inouye, Takahiro; Tomita, Toshiki; Shinden, Seiichi; Takagi, Hitoshi; Kano, Shigeru.

1996-01-01

Preoperative radiological diagnosis constitutes the most important factor for the surgical treatment of hyperparathyroidism. In this regard, MRI is useful for detecting the abnormal parathyroid, but it is often difficult to localize it using MRI only. It is thus necessary to combine this procedure with excellent subtraction scintigraphy. We performed both 201 Tl- 99m Tc and 99m Tc·MIBI- 99m Tc subtraction scintigraphy in seven patients with primary hyperparathyroidism and compared them the radiological results. Five patients presented parathyroid adenomas and the rest hypertrophy of the parathyroid. We could detect the abnormal parathyroid in four patients (57.1%) by 201 Tl- 99m Tc subtraction scintigraphy and in six patients (85.7%) by 99m Tc·MIBI- 99m Tc subtraction scintigraphy. We therefore believe that 99m Tc·MIBI- 99m Tc subtraction scintigraphy will become an essential examination for primary hyperparathyroidism rather than the presently employed 201 Tl- 99m Tc subtraction scintigraphy. (author)

A new protocol of dual energy acquisition on stress 201Tl and rest 99mTc-tetrofosmin myocardial scintigraphy

International Nuclear Information System (INIS)

Maeno, Masakazu; Matsuo, Takeshi; Imamura, Takurou; Koiwaya, Yasushi; Eto, Tanenao; Nagamachi, Shigeki; Jinnouchi, Seishi

2001-01-01

We carried out stress 201 Tl (Tl) and rest 99m Tc-tetrofosmin (TF) myocardial scintigraphy with dual energy acquisition in 24 patients with suspected ischemic heart disease performed coronary arteriography and elucidated the sensitivity of this method. One hour after light meal eating, TF (555 MBq) was injected intravenously at rest and after 3 minutes from injection of TF exercise or pharmacologic stress was performed. During stress Tl (111 MBq) was injected intravenously before end-point or at adequate point of pharmacologic stress. Dual energy acquisition using triple energy windows (TEW) was started after 5 minutes (early) and 4 hours (delayed) from stress. The sensitivity (Sn), specificity (Sp) and accuracy (Ac) in diagnosis of non-infarcted branches by using Tl (early)-TF (rest) and Tl (early)-Tl (delayed) were 79% vs. 53% (Sn), 78% vs. 96% (Sp) and 79% vs. 71% (Ac) respectively. Accordance of uptake score of infarcted region between TF (rest) and Tl (delayed) was 70%. In conclusion, this protocol is seemed to be useful as usual protocol for detection of myocardial ischemia and viability during about only 1 hour. (author)

Effect of Temperature and Mole Ratio on the Synthesis Yield of Rhenium-Tetrofosmin

Directory of Open Access Journals (Sweden)

Widyastuti

2015-08-01

Full Text Available Technetium-99m (99mTc tetrofosmin is widely used in nuclear medicine as a diagnostic agent for myocardial perfusion and as a tumor imaging agent. As a parenteral preparation it requires an evaluation of its pharmacokinetics and stability in-vivo. Since 99mTc has a short half-life and is only available in very low concentrations, it is impossible to characterize its chemical properties and presence in the body. Due to this reason, only technetium-99 (T1/2 = 5 × 105 years, which is available in macro quantities, or natural rhenium can be used for this purpose. In this study rhenium-188 (188Re tetrofosmin will be synthesized and applied, because non-radioactive Re can be easily obtained. Synthesis and radiochemical purity analysis of carrier-added 188Re-tetrofosmin were carried out as a model to study the in-vivo stability of technetium-99m tetrofosmin. Rhenium-188 was used as a tracer to identify the formation of rhenium tetrofosmin. Rhenium gluconate was synthesized first prior to the formation of rhenium tetrofosmin. The quality of labeling for both rhenium gluconate and rhenium tetrofosmin was analyzed using paper- and thin-layer chromatography, respectively. Rhenium gluconate can be synthesized with high labeling yield within 1 hour, whereas rhenium tetrofosmin was synthesized both in room temperature and in an elevated temperature with various tetrofosmin-to-rhenium mole ratios.The results showed that heating at 95oC led to a higher yield of more than 90% within 30 minutes. Rhenium tetrofosmin could be produced in high radiochemical purity using an excess of tetrofosmin with mole ratio of 2000. It is concluded that rhenium tetrofosmin could be synthesized through the formation of rhenium gluconate, and a higher yield could be obtained in a shorter time by heating process.

Relationship between lung-to-heart uptake ratio of technetium-99m-tetrofosmin during exercise myocardial single photon emission computed tomographic imaging and the number of diseased coronary arteries in patients with effort angina pectoris without myocardial infarction

International Nuclear Information System (INIS)

Okajima, Toshiya; Ueshima, Kenji; Nishiyama, Osamu; Ogawa, Muneyoshi; Ohuchi, Mami; Saitoh, Masahiko; Hiramori, Katsuhiko

2004-01-01

Increased lung uptake of thallium-201 in exercise myocardial perfusion imaging is a reliable marker of multivessel disease in patients with ischemic heart disease. This study investigated whether the lung-to-heart uptake ratio with technetium-99m ( 99m Tc)-tetrofosmin also provides valuable information to detect patients with multivessel disease. Fifty-three consecutive patients (35 men, 18 women, mean age 66±11 years; single-vessel disease: 29, double-vessel disease: 16, triple-vessel disease: 8) with stable effort angina pectoris without prior myocardial infarction and 17 control subjects (12 men, 5 women, mean age 62±9 years) underwent exercise myocardial perfusion imaging with 99m Tc-tetrofosmin and coronary angiography in January 2000 to December 2002. The lung-to-heart uptake ratio was calculated on an anterior projection before reconstruction of the exercise single photon emission computed tomographic images. The mean lung-to-heart uptake ratio was 0.34±0.04, 0.38±0.07, 0.41±0.05, and 0.46±0.09, in patients with normal coronary, single-vessel disease, double-vessel disease, and triple-vessel disease, respectively. Significantly higher lung-to-heart uptake ratio was associated with more diseased vessels (p 99m Tc-tetrofosmin can provide clinically useful information to detect multivessel disease in patients with ischemic heart disease. (author)

Determination of 99Mo contamination in 99mTc elute obtained from 99Mo/99mTc- generator

International Nuclear Information System (INIS)

Momennezhad, M.; Zakavi, S. R.; Sadeghi, R.

2010-01-01

99m Tc is a widely used radioisotope in nuclear medicine centers which is obtained by elution from Mo-99/Tc-99m generators. Usually the generators are either supplied by the Iran Atomic Energy Agency or by private companies from foreign countries. In this study we have measured 99 Mo contamination in 99m Tc elute from different generators in a period of one year. Materials and Methods: The radionuclide impurity of the 99m Tc elute were studied in two types of radionuclide generators (A: produced in Iran and B: Imported from other country). In-vitro measurements were performed using dose calibrator. Direct measurements were made, using a standard canister at the time of milking of the generators and also in Subsequent hours after milking. Results: The results showed a mean of 99 Mo impurity in generators A and B to be 0.00932±0.0043 and 0.0170±0.0127 respectively. Although the results showed that the 99 Mo contamination in 99 mTc elute was lesser than the maximum accepted activity limit of 0.015%, the difference in these two types may reflect different methods of productions of generator, as well as the quality control procedures. Conclusion: The mean of 99 Mo contamination in generators produced in Iran Atomic Energy Organization was lesser than generators imported from foreign origin.

Sequential hepatobiliary scintigraphy of the patients with constitutional jaundice, ICG excretory defect disease and hepatocellular carcinoma with 99mTc-PI, 99mTc-HIDA and 99mTc-EHIDA

International Nuclear Information System (INIS)

Mitani, Tsuyoshi

1987-01-01

Sequential 2 min scintiphotos were obtained with a scintilation camera after intravenous injection of 3 mCi of 99m Tc-HIDA or 99m Tc-PI. Digital matrix images were simultaneously recorded with computer. Sequential samples for the blood clearance of 99m Tc-HIDA or 99m Tc-PI were obtained for 120 min following injection to the patient of constitutional hyperbilirubinemia and ICG excretory defect disease. In Dubin-Johnson syndrome, the hepatic uptake of 99m Tc-HIDA was faster or normal but the excretion was extremely slower than in normal cases. Both hepatic uptake and excretion of 99m Tc-PI were almost normal. In Rotor's disease, hepatic uptake of 99m Tc-HIDA or 99m Tc-PI was very poor, showing almost no hepatic images in all time. In Gilbert's disease and ICG excretory defect disease, hepatic uptake and excretion of 99m Tc-HIDA or 99m Tc-PI were within normal limit. From these results, Dubin-Johnson syndrome, Rotor's disease and Gilbert's disease show the different patterns between hepatic uptake and excretion of 99m Tc-HIDA and 99m Tc-PI hepatobiliary scintigraphy and these patterns contribute to the differential diagnosis of constitutional jaundice. The usefulness of hepatobiliary imaging with 99m Tc-EHIDA in diagnosis of hepatocellular carcinoma was studied in 15 patients with histologically verified HCC. In 15 patients, 3 patients (20 %) showed increased radioactivity with 99m Tc-EHIDA image, where liver scan with 99m Tc-Sn colloid showed filling defect. These results indicate that use of 99m Tc-EHIDA scan and 67 Ga-citrate imaging is useful for positive visualization of HCC. (author)

Tc-99m-hexakis(t-butylisonitrile)-technetium(I) (Tc-99m-TBI)

International Nuclear Information System (INIS)

Angelberger, P.; Dudczak, R.; Jones, A.G.; Lister-James, J.; Wagner-Loffler, M.; Buchheit, O.; Fally, F.

1986-01-01

The potassium analog (Tl-201)/sup +/ is widely used in nuclear cardiology but has inferior scintigraphic (80 keV photons), dosimetric and economic properties as compared to Tc-99m. Therefore considerable efforts have been made to develop a Tc-compound that would accumulate in the myocardium in relation to regional blood flow. This study was aimed at optimizing the preparation of Tc-TBI with n.c.a. Tc-99m, analyze and purify the product with HPLC, verify biodistribution in mice and undertake a clinical evaluation

Pharmaceutical grade sodium (99mTc) pertechnetate from 99Mo/99mTc-TCM-Autosolex generator

International Nuclear Information System (INIS)

Chattopadhyay, Sankha; Barua, Luna; Das, Sujata Saha

2014-01-01

Technetium-99m (T 1/2 = 6.02h; 140.51 keV (89%)) is the most useful radioisotope in diagnostic nuclear medicine. More than 80% of all diagnostic procedures done worldwide in nuclear medicine centre are performed with 99m Tc. Worldwide crisis of fission 99 Mo based generator in recent past had put the nuclear medicine fraternity in very harsh situation. In order to have an indigenous solution of this problem, we tried to develop a computer controlled semi automated 99 Mo/ 99m Tc generator using MEK solvent extraction technique, which utilizes abundantly available 99 Mo produced by (n,γ) reaction in BARC reactors. The aim of this work is to provide a more reliable, computer controlled module (TCM- AUTOSOLEX) for the recovery of pharmaceutical grade 99m Tc from low specific activity 99 Mo based on solvent extraction methodology

Technetium-99m-Sestamibi in the diagnosis of acute chest pain

International Nuclear Information System (INIS)

Gilleece, T.; Salehi, N.; Better, N.

1998-01-01

Full text: A 45-year-old male was admitted to coronary care with a two-day history of recurrent chest pain. Despite maximal medical therapy, pain persisted. Examination and ECG with pain, were normal, suspicion of ischaemia was moderately high but coronary angiography was not immediately available. Technetium-99m-Sestamibi was prepared at the start of the day according to the standard preparation protocol (Du Pont). Coronary Care informed the Nuclear Medicine Department immediately the patient experienced a further episode of chest pain. Technetium-99m-Sestamibi was administered in coronary care, 4.30 minutes after being advised of the onset of further chest pain. Images were acquired 60 minute post-injection; 15 minutes after the patient had been given 200 mL of milk. A triple-headed gamma camera was used to acquire SPECT images over a 1200 arc, 30 frames of 30 seconds using a 64 x 64 matrix. The patient was laying prone with arms raised out of the field of view. Images showed a normal distribution of technetium-99m -Sestamibi throughout the myocardium. Due to ongoing clinical suspicion by the treating physician, coronary angiography was subsequently performed. This showed normal coronary arteries. Medical therapy was ceased and the patient discharged the next day. We concluded that the chest pain at the time of injection was not ischaemic. Previous trials had shown a 95% sensitivity for this method of diagnosing ischaemia. This method permits a novel and simple technique for diagnosing myocardial ischaemia and obviating the need for cardiac catheterization in this group of patients

Technetium-99m scintimammography in the diagnosis of malignant breast tumors

Directory of Open Access Journals (Sweden)

Jauković Ljiljana

2004-01-01

Full Text Available Background. Technetium-99m (99mTc tetrofosmin scintigraphy is a new imaging method for the diagnosis of various malignancies, such as lung, thyroid, and most frequently breast neoplasms. The aim of this study was to evaluate the diagnostic reliability of 99mTc-Tetrofosmin breast scintigraphy in the detection of malignant breast disease. Methods. 99mTc -Tetrofosmin scintimammography (SMM was performed in 28 patients with 30 breast lesions suspicious for malignancy. Standard mammography (MM was also done. After surgery, the results of SMM and MM were compared to definitive histopathological findings as the "gold standard". After intravenous injection of radiotracer, SMM was performed in prone and supine views of the thorax, using large field-of-view Gamma camera. Results. The results of SMM were interpreted visually and semiquantitatively, and evaluated as positive or negative. Sensitivity, specificity and accuracy, positive (PPV and negative predictive value (NPV were obtained in relation to histopathology. After comparing the results of SMM and MM, SMM was proved more sensitive (95% for SMM vs. 80% for MM, while the specificity of both methods was similar. Conclusion. The results of this study indicate that the contribution of SMM as a nuclear medicine procedure has its place in the diagnostic protocol for patients suspected of malignant breast cancer.

Left ventricular function in response to dipyridamole stress: head-to-head comparison between {sup 82}Rubidium PET and {sup 99m}Tc-sestamibi SPECT ECG-gated myocardial perfusion imaging

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Giorgi, Maria Clementina; Meneghetti, Jose Claudio; Soares, Jose; Izaki, Marisa; Falcao, Andrea; Imada, Rodrigo; Chalela, William; Oliveira, Marco Antonio de; Nomura, Cesar [Department of Radiology and Nuclear Medicine and Molecular Imaging Service - Heart Institute of the University of Sao Paulo Medical School, Sao Paulo (Brazil); Verberne, Hein J. [University of Amsterdam, Department of Nuclear Medicine, Academic Medical Center, P.O. Box 22700, Amsterdam (Netherlands)

2017-05-15

Myocardial perfusion imaging (MPI) with {sup 99m}Tc-sestamibi (sestamibi) SPECT and rubidium-82 ({sup 82}Rb) PET both allow for combined assessment of perfusion and left ventricular (LV) function. We sought to compare parameters of LV function obtained with both methods using a single dipyridamole stress dose. A group of 221 consecutive patients (65.2 ± 10.4 years, 52.9% male) underwent consecutive sestamibi and {sup 82}Rb MPI after a single dipyridamole stress dose. Sestamibi and {sup 82}Rb summed rest (SRS), stress (SSS) and difference (SDS) scores, and LV end-diastolic (EDV) and end-systolic (ESV) volumes and left ventricular ejection fraction (LVEF) were compared. Bland-Altman analysis showed that with increasing ESV and EDV the difference between the two perfusion tracers increased both at rest and post-stress. The mean difference in EDV and ESV between the two perfusion tracers at rest could both be independently explained by the {sup 82}Rb SDS and the sestamibi SRS. The combined models explained approximately 30% of the variation in these volumes between the two perfusion tracers (R{sup 2} = 0.261, p = 0.005; R{sup 2} = 0.296, p < 0.001, for EDV and ESV respectively). However, the mean difference in LVEF between sestamibi and {sup 82}Rb showed no significant trend post-stress (R{sup 2} = 0.001, p = 0.70) and only a modest linear increase with increasing LVEF values at rest (R{sup 2} = 0.032, p = 0.009). Differences in left ventricular volumes between sestamibi and {sup 82}Rb MPI increase with increasing volumes. However, these differences did only marginally affect LVEF between sestamibi and {sup 82}Rb. In clinical practice these results should be taken into account when comparing functional derived parameters between sestamibi and {sup 82}Rb MPI. (orig.)

A comparison between 99Tcm-tetrofosmin and 99Tcm-MIBI myocardial perfusion imaging in detection of silent myocardial ischemia

International Nuclear Information System (INIS)

Fu Wei; Tang Yi; Liu Xuemei; Fan Yan; Liu Tao

2012-01-01

Objective: To compare 99 Tc m -tetrofosmin (TF) and 99 Tc m -MIBI adenosine stress/resting MPI in detection of silent myocardial ischemia (SMI). Methods: According to the WHO diagnostic criteria for coronary heart disease (CHD), 306 SMI patients were classified to three groups as type Ⅰ (n=122), type Ⅱ (n=112) and type Ⅲ (n=72). The subjects of each type were randomly divided into 2 subgroups; one subgroup underwent adenosine stress/rest MPI with 99 Tc m -MIBI and another subgroup with 99 Tc m -TF. The clinical diagnosis of CHD was proven with electrocardiogram (46 cases), dynamic electrocardiogram (219 cases) or CAG (41 cases). Comparison factors between the two tracers included image quality and diagnostic efficacy. The image quality was graded into three classes:excellent, good and moderate. χ 2 test and analysis of variance were used to analyze data. Results: The sensitivities of detecting myocardial ischemia with 99 Tc m -MIBI MPI and 99 Tc m -TF MPI in group type Ⅰ were 57.38% (35/61) vs 60.66% (37/61) (χ 2 =0.136, P>0.05); in group type Ⅱ 69.64% (39/56) vs 64.29% (36/56) (χ 2 =0.363, P>0.05) and in group type Ⅲ 83.33% (30/36) vs 88.89% (32/36) (χ 2 =0.465, P>0.05), respectively. There was no significant difference between the sensitivities of the two imaging modalities in all three types of SMI patients.In image quality grading, 99 Tc m -MIBI and 99 Tc m -TF demonstrated excellent images with 41.18% (63/153) vs 48.37% (74/153) (χ 2 =1.599, P=0.206), good with 45.10% (69/153) vs 34.64% (53/153) (χ 2 =3.489, P=0.062) and moderate with 13.72% (21/153) vs 16.99%(26/153) (χ 2 =0.628, P=0.428). There was no unqualified image with either modality. 99 Tc m -TF displayed quicker radioactivity clearance in liver and lungs. Thereby there was less interference or pitfalls present in the ventricle base or interior wall that may result from higher liver radioactivity retention. The waiting time between the tracer injection and imaging was at least 1 h

Comparison of carrier-added [99mTc] EDTMP and carrier-free preparations of [99mTc] EDTMP and [99mTc] DPD

International Nuclear Information System (INIS)

Krcal, A.; Kletter, K.; Dudczak, R.; Pirich, C.; Mitterhauser, M.

2002-01-01

Full text: High uptake of bone-seeking radiopharmaceuticals in malignant bone lesions is a prerequisite for adequate bone scanning. Visual image analysis is impaired due to high soft-tissue activity with currently available [ 99m Tc]-EDTMP-kits. This study aimed to compare carrier-added [ 99m Tc]-EDTMP with carrier-free [ 99m Tc]-EDTMP and [ 99m Tc]-DPD preparations in clinical routine. 15 μg and 150 μg perrhenic acid respectively were added to [ 99m Tc]-pertechnetate (>6 GBq in 3 ml phys. saline). The solution was then transferred into a vial, containing 1 mg of EDTMP, 3.6 mg stannous(II)chloride and 10 mg ascorbic acid under inert conditions. Under vigorous stirring the reaction mixture was heated to 45 o C for 10 min. After cooling down to room temperature the labelling mixture was sterile filtrated (millipore 0.22 μm). Quality control was performed using radio-ITLC (Whatman SG; acetone or ethanol: R f perrhenate/pertechnetate 0.87, colloid/product 0.05; phys. saline: R f colloid 0.00, perrhenate/pertechnetate and product 0.9) allowing rapid and efficient assessment of the product. Carrier free [ 99m Tc]-EDTMP and [ 99m Tc]-DPD were prepared according to instructions of the manufacturer. Clinical studies were performed in 29 patients according to a routine bone scanning protocol by injecting 700-800 MBq of the respective tracer and whole body imaging 3 h thereafter. Radiochemical purity and radiochemical yield relied on various parameters such as concentration of carrier and reducing agent and reaction conditions (pH, reaction time, temperature). Means of the labelling yield were 22 % for the preparation using 150 μg of carrier (5 preparations), 80 % for the preparation using 15 μpg of carrier (10 preparations) and 91 % for the carrier free products (5 preparations). Radiochemical purity was >96 % in all experiments. Colloid was formed in very low amounts, and was completely removed by sterile filtration. In clinical studies quantitative analysis

Concentration of sup(99m)Tc from the eluate of 99Mo-sup(99m)Tc generators

International Nuclear Information System (INIS)

Saucedo, T.; Mora, M.; Fraga de Suarez, A.H.; Mitta, A.E.A.

1976-04-01

A method is described to concentrate sup(99m)Tc solutions, originated in 99 Mo-sup(99m)Tc generators, independent of its age. The techniques of preparation of the different radiopharmaceuticals used in nuclear medicine are also described. (author) [es

99mTc-MAG3: can it be a viable alternative to 99mTc-DTPA ?

International Nuclear Information System (INIS)

Bal, C.S.; Padhy, A.K.; Nair, R.; Gopinath, P.G.

1991-01-01

The purpose of this study was to assess the potentials of 99m Tc MAG 3 to replace universally used 99m Tc-DTPA as a routine renal agent. Five patients with different nephrological problems were first studied with 99m Tc MAG 3 and then reinvestigated with 99m Tc-DTPA two to seven days later. Renal MAG 3 gamma camera images were found to be almost identical with those of 99m Tc-DTPA images except high hepatic and splenic uptake of the former compound in four out of five patients (80%) irrespective of kidney function. MAG 3 and DTPA renograms showed identical differential renal uptake function (r=0.87) with slightly higher uptake in right kidneys. Time to reach the peak correlated well (r=0.91). Time to reach half maximum renal activity was also found to be almost identical (r=0.97) for MAG 3 and DTPA. It was felt that the age old 99m Tc-DTPA is as good a compound as 99m Tc MAG 3 with regard to imaging and assessment of renal uptake, drainage and differential renal functions. 99m Tc-DTPA is much cheaper, readily available in India and stable to suit the logistics in a busy nuclear medicine department for routine renography. (author). 10 refs., 2 figs., 3 tabs

99mTc-ECD and 99mTc-HM-PAO SPECT in five patients with MELAS

International Nuclear Information System (INIS)

Katagiri, Shinako; Nishimaki, Hiroshi; Kitano, Masashi; Horiike, Shigeharu; Kan, Shinichi; Ishii, Katsumi; Matsubayashi, Takashi; Sakai, Fumihiko

1998-01-01

Cerebral perfusion was studied in five patients with mitochondrial encephalomyopathy with lactic acidosis and stroke-like episodes syndrome (MELAS), using single photon emission computed tomography (SPECT) with 99m Tc-ethyl cysteinate dimer ( 99m Tc-ECD) or 99m Tc-hexamethyl propyleneamine oxime ( 99m Tc-HM-PAO). In four cases, regional cerebral blood flow (rCBF) was evaluated by the method reported by Mastuda et al. Immediately after the stroke-like episodes, accumulation of the tracer was relatively increased in the temporooccipital lobe, and also increased rCBF was shown in the same area. However, the region showed decreased radioactivity at the chronic stage, and rCBF decreased also. These findings are consistent with positron emission tomography (PET) at the acute stage and autopsy. 99m Tc-ECD SPECT and 99m Tc-HM-PAO SPECT may be useful in the diagnosis and assessment of the progress of the MELAS. (author)

Imaging of irradiated liver with Tc-99m-sulfur colloid and Tc-99m-IDA

International Nuclear Information System (INIS)

Gelfand, M.J.; Saha, S.; Aron, B.S.

1981-01-01

In three cases, irradiated regions of liver failed to concentrate Tc-99m-sulfur colloid. In two of these three, imaging with Tc-99m-acetanilide iminodiacetic acid (IDA) agents within five days showed near normal hepatic uptake of this hepatobiliary imaging agent. The hepatic parenchymal cells may be imaged with Tc-99m-IDA in some irradiated regions of liver, despite loss of reticuloendothelial cell function

Kinetic study on ligand exchange reaction between ethylenedicysteine and 99mTc- glucoheptonate (99mTc-GH)

International Nuclear Information System (INIS)

Wu, C.Y.; Ji, S.R.; Lu, C.X.; Ding, S.Y.; Chen, Z.P.; Lin, X.T.

2002-01-01

Aim: 99m Tc-L,L-ethylenedicysteine( 99m Tc-EC)is a new type of renal imaging agent. It can be labeled very easily and efficiently at room temperature through direct labeling at pH 12. The need for direct labeling at pH 12 does not compromise the simplicity and ease of preparation of 99m Tc-EC and its practical usefulness in daily routine. On the basis of the labeling experiments, we developed a ligand exchange labeling method, in which the labeling EC with 99m Tc can be performed at pH 8. In order to provide a theoretic basis, a detailed kinetic study of ligand exchange reaction between 99m Tc- glucoheptonate( 99m Tc-GH) and EC was carried out. Materials and Methods: 99m Tc-EC is prepared as follows: 99m Tc-GH + EC → 99m Tc-EC + GH, labeling can be easily performed by adding 99m TcO 4 - (2∼6ml generator elute) to glucoheptonate solution containing SnCl 2 .2H 2 O solution to form 99m Tc-GH, then freshly prepared 99m Tc-GH is transferred to the aqueous solution of different concentrations of EC at different pH value, after being shaken, 99m Tc-EC was formed. Radiolabeling yield(RLY) and radiochemical purity(RCP) of 99m Tc-GH and 99m Tc-EC were measured by Xinhua No.1 paper with developing system of Me 2 CO/H 2 O/con.NH 3 .H 2 O=9/3/1(V/V). 99m Tc-GH(RCP must be over 98%, 80ul, 3.6∼7.4MBq) was added to 1ml of 0.5mol/L phosphate buffer(pH 12) containing different amount of EC(150, 75, 50 and 15ug), the sample was taken out at different time intervals and RCP was determined. The solution of EC(30ul, 5g/L) was added to 1ml of 0.5mol/L phosphate buffer at different pH value(pH11, 10, 9, 8, 7), after completely vortexed, 99m Tc-GH(RCP must be over 98%, 80ul, 3.6∼7.4MBq) was then added, the sample was taken out and RCP was determined as above. The rate constant(k) of ligand exchange reaction at different concentrations of EC and different reaction pH values were calculated out by integrating. Plot ln[1/(1-RLY)] vs t(time) showed a liner relationship, and the rate

Status of Tc-99m and 99Mo/99mTc generator production in Bangladesh

International Nuclear Information System (INIS)

Abedin, Md. Zainul; Haque, Md. Azizul; Ali, Md. Ramjan; Hossain, Md. Anwar; Razzaque, Md. Abdur; Yasmin, Lyzu; Waheed, M. Fatima; Akhter, Rabeya; Mondal, Rafiuddin

2007-01-01

Radioisotope Production Division (RIPD) produced instant technetium-99m by solvent extraction method for several years. On R and D basis, the division produced portable sterile Tc-99m sublimation generator by irradiating titanium molybdate in the reactor. The division produced (4/batch) from imported fission Mo-99 till June 2005. Since August 2005, as per demand of the government hospitals, the division have been producing 12-14 pieces of 15 GBq chromatographic 99m Tc-generators weekly by using the new generator production plant installed last year having online Mo-99 loading system with the of producing 50 generator per batch. Development of PZC and (n,γ) 99 Mo based generator holds potential in Bangladesh. (author)

Clinical application of 99mTc-DTPA-HSA

International Nuclear Information System (INIS)

Kawamura, Yasuaki; Yamazaki, Junichi; Okuzumi, Ichio

1989-01-01

A newly developed blood pool imaging agent, Tc-99m DTPA-HSA (Tc-99m HSA-D), was clinically assessed in blood pool studies of patients with heart disease. Twenty mCi of Tc-99m HSA-D was iv injected to the patients. Similarly, conventional Tc-99m HSA was injected one week later for comparison. Blood counts of Tc-99m HSA-D were significantly higher than those of Tc-99m HSA at 30 minutes after iv injection (p<0.01) and at one, 3, and 6 hours (p<0.001). For the heart, liver, and lungs, sequential counts of Tc-99m HSA-D were also significantly higher than those of Tc-99m HSA. Free Tc-99m uptake in the stomach, thyroid gland, and kidneys was higher on Tc-99m HSA images than Tc-99m HSA-D images. Hepatic and pulmonary uptake of free Tc-99m that were visualized on Tc-99m HSA-D did not influence the diagnostic ability. None of the patients had clinical toxicity of Tc-99m HSA-D. The results indicate that Tc-99m HSA-D is a stable blood pool imaging agent. (Namekawa, K)

Results of regular study on radionuclidic purity of sup(99m)Tc obtained from 99Mo-sup(99m)Tc generators

International Nuclear Information System (INIS)

Vlcek, J.; Rohacek, J.; Husak, V.

1979-01-01

A total of 39 sup(99m)Tc eluates obtained from 9 99 Mo-sup(99m)Tc generators delivered by The Radiochemical Centre Amersham during one year was studied with regard to their radionuclide purity. Using a Ge(Li) spectrometer the contaminants 60 Co, 103 Ru, 131 I, 134 Cs, 140 La and 188 Re were found in sup(99m)Tc-eluates with average levels ranging from 2.9 x 10 -3 to 2.8 x 10 -1 per cent of sup(99m)Tc activity. The additional total body absorbed dose caused by these contaminants, as calculated from their average content in sup(99m)Tc eluates, was less than 1% of the dose due to sup(99m)Tc pertechnetate. (orig.) 891 MG/orig. 892 CS [de

Direct {sup 99m}Tc labeling of Herceptin (trastuzumab) by {sup 99m}Tc(I) tricarbonyl ion

Energy Technology Data Exchange (ETDEWEB)

Chen, W.-J.; Yen, C.-L.; Lo, S.-T.; Chen, K.-T. [Department of Biomedical Engineering and Environmental Sciences, National Tsing Hua University, Hsinchu 30013, Taiwan (China); Lo, J.-M. [Department of Biomedical Engineering and Environmental Sciences, National Tsing Hua University, Hsinchu 30013, Taiwan (China)], E-mail: jmlo@mx.nthu.edu.tw

2008-03-15

By simply incubating Herceptin (trastuzumab) with [{sup 99m}Tc(CO){sub 3}(OH{sub 2}){sub 3}]{sup +} ion in saline, a significant yield of {sup 99m}Tc-labeled trastuzumab was found to be achievable. The effective labeling may be based on that trastuzumab is inherent with endogenous histidine group to which {sup 99m}Tc(I) tricarbonyl ion can be strongly bound. For practical {sup 99m}Tc labeling processing, trastuzumab was purified beforehand from the commercial product, Herceptin (Genentech) via size exclusion chromatography to remove the excipient, {alpha}-histidine and a high-labeled yield could be obtained by incubating the purified trastuzumab with [{sup 99m}Tc(CO){sub 3}(OH{sub 2}){sub 3}]{sup +}. Retention of bioactivity of the {sup 99m}Tc(I)-labeled trastuzumab was validated using a cell binding test.

Successful labeling of 99mTc-MDP using 99mTc separated from 99Mo produced by 100Mo(n,2n)99Mo

International Nuclear Information System (INIS)

Nagai, Yasuki; Hatsukawa, Yuichi; Kin, Tadahiro; Hashimoto, Kazuyuki; Motoishi, Shoji; Konno, Chikara; Ochiai, Kentaro; Takakura, Kosuke; Sato, Yuichi; Sato, Norihito; Ohta, Akio; Yamabayashi, Hisamichi; Tanase, Masakazu; Fujisaki, Saburo; Kawauchi, Yukimasa; Teranaka, Tomoyuki; Takeuchi, Nobuhiro; Igarashi, Takashi

2011-01-01

We have for the first time succeeded in separating 99m Tc from a MoO 3 sample irradiated with accelerator neutrons free from any radioactive impurities and in formulating 99m Tc-methylene diphosphonate ( 99 mTc-MDP). 99 Mo, the mother nuclide of 99m Tc, was produced by the 100 Mo(n,2n) 99 Mo reaction using about 14 MeV neutrons provided by the 3 H(d,n) 4 He reaction at the Fusion Neutronics Source of Japan Atomic Energy Agency. The 99m Tc was separated from 99 Mo by sublimation and its radionuclide purity was confirmed to be higher than 99.99% by γ-spectroscopy. The labeling efficiency of 99m Tc-MDP was shown to be higher than 99% by thin-layer chromatography. These values exceed the United States Pharmacopeia requirements for a fission product, 99 Mo. Consequently, a 99m Tc radiopharmaceutical preparation formed by using the mentioned 99 Mo can be a promising substitute for the fission product 99 Mo, which is currently produced using a highly enriched uranium target in aging research reactors. A longstanding problem to ensure a reliable and constant supply of 99 Mo in Japan can be partially mitigated. (author)

Comparison of sup(99m)Tc-MDP to sup(99m)Tc-pertechnetate by computerized quantitative joint scintigraphy

International Nuclear Information System (INIS)

Rekonen, A.; Moettoenen, T.; Oka, M.

1982-01-01

99mTc-pertechnetate was compared to 99mTc-MDP in joint pairs with asymmetric arthritis. Markedly elevated joint activity ratios (inflamed/uninflamed joint) were measured in all the joint pairs studied. In the joints affected by reactive arthritis and without roentgenologic changes the mean joint activity was the same with both tracers. A very high activity ratio with 99mTc-MDP was found in septic arthritis. In rheumatoid arthritis the sensitivity of 99mTc-MDP as an indicator of active arthritis seemed to be better than that of 99mTc-pertechnetate. Even in joints without erosions in roentgenograms the joint activity ratios were markedly elevated with 99mTc-MDP. This suggests, that high activity in 99mTc-MDP scanning might be prognostic of erosive joint changes. In this work a profile curve was used for quantitation differences between joints

Evaluation of left ventricular ejection fraction from radial long-axis tomography. A new reconstruction algorithm for ECG-gated technetium-99m Sestamibi SPECT

International Nuclear Information System (INIS)

Tsujimura, Eiichiro; Kusuoka, Hideo; Uehara, Toshiisa

1997-01-01

Radial long-axis tomography can provide views similar to contrast left ventriculography (LVG) including the basal and apical areas of the left ventricle, not possible in routine short-axis tomography. We applied this method to ECG-gated Tc-99m Sestamibi (MIBI) myocardial SPECT images to estimate the left ventricular ejection fraction (LVEF). ECG-gated Tc-99m MIBI SPECT was performed with a temporal resolution of 10 frames per R-R interval. LVEF was calculated on the basis of left ventricular volume estimates at end diastole (ED) and end systole (ES) with using an ellipsoid body model. To validate this method, LVEF's derived from ECG-gated Tc-99m MIBI SPECT were compared with those from LVG in 11 patients with coronary artery disease. There was a close linear correlation between LVEF values calculated from Tc-99m MIBI SPECT and those from LVG (r=0.89, p<0.001), although the gated SPECT underestimated LVEF compared to LVG. The technique showed excellent reproducibility (intra-observer variability, r=0.96, p<0.001; inter-observer variability, r=0.71, p<0.005). The radial long-axis tomography technique gives a good estimate of LVEF, in agreement with estimates based on LVG. ECG-gated Tc-99m MIBI SPECT can, therefore, be applicable to assess myocardial perfusion and ventricular function at the same time. (author)

Evaluation of left ventricular ejection fraction from radial long-axis tomography. A new reconstruction algorithm for ECG-gated technetium-99m Sestamibi SPECT

Energy Technology Data Exchange (ETDEWEB)

Tsujimura, Eiichiro; Kusuoka, Hideo; Uehara, Toshiisa [Osaka Univ. (Japan). Faculty of Medicine] [and others

1997-08-01

Radial long-axis tomography can provide views similar to contrast left ventriculography (LVG) including the basal and apical areas of the left ventricle, not possible in routine short-axis tomography. We applied this method to ECG-gated Tc-99m Sestamibi (MIBI) myocardial SPECT images to estimate the left ventricular ejection fraction (LVEF). ECG-gated Tc-99m MIBI SPECT was performed with a temporal resolution of 10 frames per R-R interval. LVEF was calculated on the basis of left ventricular volume estimates at end diastole (ED) and end systole (ES) with using an ellipsoid body model. To validate this method, LVEF`s derived from ECG-gated Tc-99m MIBI SPECT were compared with those from LVG in 11 patients with coronary artery disease. There was a close linear correlation between LVEF values calculated from Tc-99m MIBI SPECT and those from LVG (r=0.89, p<0.001), although the gated SPECT underestimated LVEF compared to LVG. The technique showed excellent reproducibility (intra-observer variability, r=0.96, p<0.001; inter-observer variability, r=0.71, p<0.005). The radial long-axis tomography technique gives a good estimate of LVEF, in agreement with estimates based on LVG. ECG-gated Tc-99m MIBI SPECT can, therefore, be applicable to assess myocardial perfusion and ventricular function at the same time. (author)

Breast-milk radioactivity after a Tc-99m DTPA aerosol/Tc-99m MAA lung study

International Nuclear Information System (INIS)

Mountford, P.J.; Hall, F.M.; Wells, C.P.; Coakley, A.J.

1984-01-01

Measurements were made of the concentration of Tc-99m activity in samples of breast milk following an administration of Tc-99m DTPA aerosol for a lung ventilation image and one of Tc-99m MAA for lung perfusion. The activity was 222 nCi/ml of milk (8.2 kBq/ml) at 2 hr after the MAA injection, and it was found to be excreted exponentially with an effective half-life of 4.6 hr. There was a small incorporation of Tc-99m into breast-milk protein. The authors conclude that the combined use of these two Tc-99m agents did not indicate the interruption of breast feeding beyond 24 hr after administration of the MAA, and that for an aerosol ventiliation study alone, breast feeding need not be interrupted for more than 4 hr after the test

sup(99m)Tc-2-mercaptopropionylglycine

International Nuclear Information System (INIS)

Saji, Hideo; Odori, Teruo; Morita, Rikushi; Yokoyama, Akira; Tanaka, Hisashi.

1979-01-01

Labeling of 2-mercaptopropionylglycine (2-MPG) with sup(99m)Tc, was studied and its chemical characteristics were examined. Further, biliary excretion behavior of this complex was comparatively estimated in mice, rats and rabbits. sup(99m)Tc-2-MPG was rapidly excreted in large quantities into the bile in mice and rats: within 1 hr after injection, 51% of the injected dose was recovered from the bile in rats. On the other hand, the ligand exchange reaction between this complex and penicillamine indicates that a low hydrolyzed sup(99m)Tc species is coordinated with 2-MPG. These results suggest that a low hydrolyzed sup(99m)Tc state is an effective feature in biliary excretion behavior of sup(99m)Tc compounds. Another interesting in vivo behavior of sup(99m)Tc-2-MPG is the difference observed in mice and rabbits: in mice, very high sup(99m)Tc activity is concentrated in the gallbladder and the clearance from tissues other than the gallbladder is rapid, whereas in rabbits, although a rapid and high excretion into the gallbladder is observed, a considerable high sup(99m)Tc activity is retained in the liver and the kidney. One reason for this different in vivo behavior is the low stability of this complex at high dilution: a big animal has the large dilution volume which lead to higher decomposition estimated by the higher liver and kidney retention or the lower bile excretion. In conclusion, studies carried on sup(99m)Tc-2-MPG showed a good biliary excretion behavior but an in vivo unstableness in big animals. (author)

99mTc-HYNIC-derivatized ternary ligand complexes for 99mTc-labeled polypeptides with low in vivo protein binding

International Nuclear Information System (INIS)

Ono, Masahiro; Arano, Yasushi; Mukai, Takahiro; Fujioka, Yasushi; Ogawa, Kazuma; Uehara, Tomoya; Saga, Tsuneo; Konishi, Junji; Saji, Hideo

2001-01-01

6-Hydrazinopyridine-3-carboxylic acid (HYNIC) is a representative agent used to prepare technetium-99m ( 99m Tc)-labeled polypeptides with tricine as a coligand. However, 99m Tc-HYNIC-labeled polypeptides show delayed elimination rates of the radioactivity not only from the blood but also from nontarget tissues such as the liver and kidney. In this study, a preformed chelate of tetrafluorophenol (TFP) active ester of [ 99m Tc](HYNIC)(tricine)(benzoylpyridine: BP) ternary complex was synthesized to prepare 99m Tc-labeled polypeptides with higher stability against exchange reactions with proteins in plasma and lysosomes using the Fab fragment of a monoclonal antibody and galactosyl-neoglycoalbumin (NGA) as model polypeptides. When incubated in plasma, [ 99m Tc](HYNIC-Fab)(tricine)(BP) showed significant reduction of the radioactivity in high molecular weight fractions compared with [ 99m Tc](HYNIC-Fab)(tricine) 2. When injected into mice, [ 99m Tc](HYNIC-NGA)(tricine)(BP) was metabolized to [ 99m Tc](HYNIC-lysine)(tricine)(BP) in the liver with no radioactivity detected in protein-bound fractions in contrast to the observations with [ 99m Tc](HYNIC-NGA)(tricine) 2. In addition, [ 99m Tc](HYNIC-NGA)(tricine)(BP) showed significantly faster elimination rates of the radioactivity from the liver as compared with [ 99m Tc](HYNIC-NGA)(tricine) 2. Similar results were observed with 99m Tc-labeled Fab fragments where [ 99m Tc](HYNIC-Fab)(tricine)(BP) exhibited significantly faster elimination rates of the radioactivity not only from the blood but also from the kidney. These findings indicated that conjugation of [ 99m Tc](HYNIC)(tricine)(BP) ternary ligand complex to polypeptides accelerated elimination rates of the radioactivity from the blood and nontarget tissues due to low binding of the [ 99m Tc](HYNIC)(tricine)(BP) complex with proteins in the blood and in the lysosomes. Such characteristics would render the TFP active ester of [ 99m Tc](HYNIC)(tricine)(BP) complex

The role of Tc-99m IDA hepatobiliary and Tc-99m colloid hepatic imaging in primary biliary cirrhosis

International Nuclear Information System (INIS)

Aburano, T.; Yokoyama, K.; Shuke, N.; Kinuya, S.; Takayama, T.; Tonami, N.; Hisada, K.

1991-01-01

To assess the presence of primary biliary cirrhosis, 15 patients at various histopathologic stages were studied by Tc-99m IDA hepatobiliary and/or Tc-99m colloid hepatic imaging. In the earlier stages (I and II), seven of eight patients (88%) showed uniform hepatic retention of Tc-99m IDA. Of seven patients in the same stage, however, four (57%) showed no abnormality on Tc-99m colliod imaging. In three of these four negative patients (75%), uniform hepatic retention of Tc-99m IDA was noted. In the later stages (III and IV), all seven patients showed decreased clearance with or without delayed tracer appearance in the intestine and prominent hepatic retention on Tc-99m IDA imaging; with Tc-99m colloid imaging there was enlargement of the spleen and increased activity in the spleen and bone marrow. Thus, Tc-99m IDA imaging is considered to be more useful in revealing this functional disorder at the earlier stage of primary biliary cirrhosis and in evaluating progression from an earlier to a later stage of disease. Tc-99m colloid imaging also effectively evaluated progression

The key role of {sup 99m}Tc-MIBI SPECT/CT in the diagnosis of parathyroid adenoma: a case report

Energy Technology Data Exchange (ETDEWEB)

Li, Qing; Pan, Jiemin; Luo, Quanyong; Wang, Yan; Bao, Yuqian; Jia, Weiping, E-mail: wpjia@sjtu.edu.cn, E-mail: wpjia@yahoo.com [Shanghai Jiao Tong University Affiliated Sixth People' s Hospital, Shanghai (China)

2015-06-15

The concomitant occurrence of primary hyperparathyroidism (PHPT) due to parathyroid adenoma and papillary thyroid carcinoma (PTC) is not common. The co-occurrence of parathyroid tumors and thyroid diseases can lead to misdiagnosis owing to mutual interference of imaging in the early period of disease. The most commonly used imaging techniques for the preoperative localization of parathyroid and thyroid adenomas are technetium-99m sestamibi ({sup 99m}Tc-MIBI) scintigraphy and ultrasonography of the neck. Recently, {sup 99m}Tc-MIBI single-photon emission computed tomography associated with computed tomography scintigraphy (SPECT/CT) has been used to detect PHPT, and its diagnostic value is being evaluated. Herein, we report a patient with an unusual co-occurrence of parathyroid adenoma and multiple thyroid diseases, including papillary thyroid carcinoma, thyroid adenoma and lymphocytic thyroiditis, which were localized with {sup 99}mTc-MIBI SPECT/CT and confirmed surgically. We suggest that {sup 99m}Tc-MIBI SPECT/CT can play an important role in the diagnosis of parathyroid and thyroid lesions. (author)

Using radioisotopes compounds (99mTc-infecton and 99mTcHIG) in evaluating and examination of pulmonary tuberculosis patients

International Nuclear Information System (INIS)

Moustafa, H. M.; Abdul-Hakeem, O.; Mohammad, K.; Briton, K.

2000-01-01

This study examined 40 patients: 34 have pulmonary tuberculosis, 3 have pneumonitis, 2 have lung cancer, and one has bilharziasis. All patients have been imaged using radioisotopes compounds (99mTc-infecton and 99mTcHIG) and after 1 hour and 4 hours of patients injection.Using 99mTc-infecton gave positive results in 30 pulmonary tuberculosis patients out of 34, the 3 pneumonitis patients, while using 99mTcHIG gave positive results in 27 pulmonary tuberculosis patients including the 3 pneumonitis patients. Both 99mTc-infecton and 99mTcHIG gave negative results with the lung cancer patients and unreal positive results with the bilharziasis patient. It has been found that the sensitivity and accuracy in the examinations using 99mTc-infecton were 88%, 93%, and 85.7% respectively in comparison with using 99mTcHIG where the values were 70.6%, 91%, and 68.5% respectively. Continuing examination and monitoring of 18 tuberculosis patients for 2-18 months with anti-pulmonary tuberculosis treatment, showed complete response of 12 patients using 99mTc-infecton, and 8 by using 99mTcHIG. As a result, 99mTc-infecton can be used for examining pulmonary tuberculosis patients

Improved brain scan specificity utilizing /sup 99m/Tc-pertechnetate and /sup 99m/Tc(Sn)-diphosphonate

International Nuclear Information System (INIS)

Fischer, K.C.; McKusick, K.A.; Pendergrass, H.P.; Potsaid, M.S.

1975-01-01

Each of 36 patients was studied with two separate brain scans performed sequentially after the injection of 20 mCi of /sup 99m/Tc-pertechnetate or 20 mCi of /sup 99m/Tc(Sn)-diphosphonate. The resulting scans were qualitatively compared, and lesion-to-nonlesion ratios of activity determined. Diagnoses were established by clinical criteria and were supported in the majority of cases by computerized axial tomography or roentgen angiography or both. Histologic confirmation was available in five cases of tumor and in the single cases of subdural hematoma and cerebral abscess. Of 22 cerebral infarctions, 15 were better demonstrated with /sup 99m/Tc-(Sn)-diphosphonate than with /sup 99m/Tc-pertechnetate. Of the seven remaining cases, three were visualized equally well with each agent, and three were better demonstrated with /sup 99m/Tc-pertechnetate. One was not seen with either agent. Of the 12 tumors, 11 were visualized better with /sup 99m/Tc-pertechnetate than with /sup 99m/Tc(Sn)-diphosphonate while in one case the lesion was seen equally as well with both agents. In no case was a lesion definitely seen with one radio- pharmaceutical and not with the other. These results indicate that this dual method is helpful in differentiating gliomas and metastases from cerebral infarctions. (U.S.)

Radiopharmacokinetic data for 99mTc-ABP - A new radiopharmaceutical for bone scanning: Comparison with 99mTc-MDP

International Nuclear Information System (INIS)

Murphy, Consuelo Arteaga de; Melendez-Alafort, Laura; Montoya-Molina, Carlos E.; Sepulveda-Mendez, Jesus

1997-01-01

Technetium-99m-labeled alendronate is a new radiopharmaceutical for bone scanning developed under strict quality control at the INNSZ. The purpose of this work was to compare the radiopharmacokinetic data and the dosimetry of 99m Tc-ABP and 99m Tc-MDP in 10 volunteers, after it was tested in laboratory animals. 99m Tc-ABP has shorter mean residence time (MRT) and t (1(2)) β; is less protein bound; has a higher renal clearance; smaller Vdss, and similar bone uptake at 1 and 2 h. 99m Tc-ABP gives less radiation exposure to the patient with a 740 MBq dose, and the quality of the bone scan is excellent. 99m Tc-ABP is a better radiopharmaceutical than 99m Tc-MDP for bone scanning

The scintigraphy of sacroiliac joints. A comparison of 99mTc-DPD and 99mTc-MDP

International Nuclear Information System (INIS)

Lantto, T.

1990-01-01

The accumulation of 99m Tc-methylene diphosphonate ( 99m Tc-MDP) and 99m Tc-dicarboxypropane diphosphonate ( 99m Tc-DPD) in sacroiliac (si) joints was evaluated as a function of imaging time in 22 control patients and 5 patients with sacroiliitis. The controls were injected with either 99m Tc-DPD or 99m Tc-MDP (12 and 10 patients, respectively) and the patients with sacroiliitis with both agents within 5 days. Both the anterior and posterior views of the si joints were taken. The sacroiliac joint-to-sacrum (SI/S) ratio was calculated with the region of interest method. No statistically significant differences between these bone-seeking agents were found in the SI/S ratios of the control or the diseased patients. A clear overlap of indices (mean±SD) was found between the control patients and the patients with sacroiliitis. When the inflamed si joint was divided into three small adjacent areas and the SI/S ratios calculated for these areas, a statistically significant (P 99m Tc-DPD and in most patients injected with 99m Tc-MDP. In the posterior views, the significance was less marked. In every case, the inflamed part of the si joint was visible in the anterior views. The background subtraction had the greatest effect on the SI/S ratio of anterior images, but in the posterior views no significance was found. The low specificity of sacroiliac joint imaging must be taken into consideration when the results are interpreted. (orig.)

Different uptake of 99mTc-ECD adn 99mTc-HMPAO in the same brains: analysis by statistical parametric mapping.

Science.gov (United States)

Hyun, Y; Lee, J S; Rha, J H; Lee, I K; Ha, C K; Lee, D S

2001-02-01

The purpose of this study was to investigate the differences between technetium-99m ethyl cysteinate dimer (99mTc-ECD) and technetium-99m hexamethylpropylene amine oxime (99mTc-HMPAO) uptake in the same brains by means of statistical parametric mapping (SPM) analysis. We examined 20 patients (9 male, 11 female, mean age 62+/-12 years) using 99mTc-ECD and 99mTc-HMPAO single-photon emission tomography (SPET) and magnetic resonance imaging (MRI) of the brain less than 7 days after onset of stroke. MRI showed no cortical infarctions. Infarctions in the pons (6 patients) and medulla (1), ischaemic periventricular white matter lesions (13) and lacunar infarction (7) were found on MRI. Split-dose and sequential SPET techniques were used for 99mTc-ECD and 99mTc-HMPAO brain SPET, without repositioning of the patient. All of the SPET images were spatially transformed to standard space, smoothed and globally normalized. The differences between the 99mTc-ECD and 99mTc-HMPAO SPET images were statistically analysed using statistical parametric mapping (SPM) 96 software. The difference between two groups was considered significant at a threshold of uncorrected P values less than 0.01. Visual analysis showed no hypoperfused areas on either 99mTc-ECD or 99mTc-HMPAO SPET images. SPM analysis revealed significantly different uptake of 99mTc-ECD and 99mTc-HMPAO in the same brains. On the 99mTc-ECD SPET images, relatively higher uptake was observed in the frontal, parietal and occipital lobes, in the left superior temporal lobe and in the superior region of the cerebellum. On the 99mTc-HMPAO SPET images, relatively higher uptake was observed in the medial temporal lobes, thalami, periventricular white matter and brain stem. These differences in uptake of the two tracers in the same brains on SPM analysis suggest that interpretation of cerebral perfusion is possible using SPET with 99mTc-ECD and 99mTc-HMPAO.

Electrolytic 99mTcO4- reduction: a different pathway to obtain 99mTc-labelled compounds

International Nuclear Information System (INIS)

Savio, E.; Kremer, C.; Gambino, D.; Kremer, E.; Leon, A.

1991-01-01

Electrolytic reduction of 99m TcO 4 - at inert electrodes to obtain 99m Tc cationic complexes and in vitro stability of labelled compounds were studied. Amines were used as neutral N-donor ligands and a systematic analysis of various parameters involved in the reduction process was performed. Usefulness of electrolytic reduction was proved as an alternative 99m Tc-labelling method. Its most important advantages are: production of complexes with a high radiochemical purity, negligible presence of red-hyd- 99m Tc, lack of foreign materials, simplicity of development and possibility of further applications. (author)

On the separation of 99mTcO4-, 99mTc-DTPA and 99mTc-citrate as marker species for the determination of Tc chemical forms in plant material using capillary zone electrophoresis

NARCIS (Netherlands)

Krijger, G.C.; Claessens, H.A.; Wolterbeek, H.Th.

1996-01-01

The present paper addresses the potential use of capillary zone electrophoresis (CZE) as an anal. tool in 99Tc speciation studies. To optimize sampling, storage and anal. procedures, the three marker compds. 99mTcO4-, 99mTc-DTPA and 99mTc-citrate were synthesized and used in test-measurements with

Radiopharmaceuticals to 99mTc

International Nuclear Information System (INIS)

Leon Cabana, Alba

1994-01-01

Studies about 99m Tc had demonstrated that have favorable properties for support diagnostic proceedings in nuclear medicine. This physical and chemical properties used for obtain another radiopharmaceuticals have been employed through re actives kits labelled with Tc 99m . A brief description was given about 99m utilities in diagnostic techniques such as endothelium reticular system,renal and hepatic studies,bone scintillators,cardiac diagnostic and cerebral perfusion

Differentiation of malignant and degenerative benign bone disease using Tc-99m Citrate and Tc-99m MDP scintigraphy

International Nuclear Information System (INIS)

Jin, J.; Guo, R.; Li, S.-J.; Ren, Y.; Zhang, C.; Zhang, X.

2007-01-01

Full text: For the evaluation of bone metastases in patients (pts) with cancer, 99mTcMDP bone scintigraphy is an important tool, but some limitations exist. One of these is the differential diagnosis of malignant and degenerative benign bone disease. The aim of this study was to differentiate them using 99mTcCitrate and 99mTcMDP scintigraphy. Methods: 39 pts (92 lesions) with known malignant or degenerative benign bone disease were studied. 23 pts had malignant bone disease (48 lesions, group 1), the other 16 pts had degenerative benign bone disease (44 lesions, group2), for which the results of 99mTcMDP scintigraphy were positive. In both groups, 99mTcCitrate scintigraphy was performed within a time interval of 2-7 days after 99mTcMDP scintigraphy (555∼740MBq. static, 3hr, planar or SPECT i m a g e s w h e n r e q u i r e d ) . The 99mTccitrate/99mTcMDP lesion-to-background radioisotope uptake ratio (RUR) was calculated for each lesion. Conventional techniques (histopathology, X-ray, CT, MRI and clinical follow up) were considered to be proof of the presence of bone metastases and degenerative benign bone disease. Results: Uptake of 99mTcMDP in the two groups is the same (1.96±0.25 vs. 1.87±0.21; t=1.178, P>0.20), while in 99mTcCitrate image, malignant lesions demonstrated a higher uptake of lesion activity than that of benign degenerative lesions (1.47±0.42 vs. 1.09±0.38; t=2.887, P<0.01). The mean 99mTccitrate/99mTcMDP RUR in the malignant group was significantly higher than the mean in the benign group (0.78±0.21 vs. 0.54±0.19; t=3.646, P<0.001). Conclusions: The preliminary results of the study confirm the usefulness and feasibility of 99mTcCitrate scintigraphy for differentiating malignant from benign degenerative lesions seen as areas of increased activity on 99mTcMDP bone scintigraphy. (author)

Evaluation of global and regional left ventricular function obtained by quantitative gated SPECT using {sup 99m}Tc-tetrofosmin for left ventricular dysfunction

Energy Technology Data Exchange (ETDEWEB)

Ban, Kazunobu; Nakajima, Tohru; Iseki, Harukazu; Abe, Sumihisa; Handa, Shunnosuke; Suzuki, Yutaka [Tokai Univ., Isehara, Kanagawa (Japan). School of Medicine

2000-08-01

The quantitative gated SPECT (QGS) software is able to calculate LV volumes and visualize LV wall motion and perfusion throughout the cardiac cycle using an automatic edge detection algorithm of the left ventricle. We evaluated the reliability of global and regional LV function assessment derived from QGS by comparing it with the results from left ventriculo-cineangiography (LVG). In 20 patients with left ventricular dysfunction who underwent ECG gated {sup 99m}Tc-tetrofosmin SPECT, the end-diastolic volume (EDV), end-systolic volume (ESV) and ejection fraction (LVEF) were calculated. The QGS-assessed regional wall motion was determined using the cinematic display. QGS-derived EDV, ESV and LVEF correlated well with those by LVG (p<0.001 for each). There was a good correlation between wall motion score (WMS) derived from the QGS and the LVG (r=0.40, p<0.05). In some patients with extensive myocardial infarction, there was a discrepancy in the regional wall motion results between QGS and LVG. The ECG-gated SPECT using QGS is useful to evaluate global and regional LV functions in left ventricular dysfunction. (author)

Value of sestamibi for the prediction of resistance to primary chemotherapy

International Nuclear Information System (INIS)

Maublant, J.; Cachin, F.; Mestas, D.

2002-01-01

Full text: Neoadjuvant chemotherapy can cause significant tumor regression of primary breast carcinoma, thus allowing a more conservative surgery to be performed in bulky tumors, even if a benefit in terms of prolongation of survival remains to be established. Clinical resistance is often encountered, but is not apparent during the first months of treatment. This has stimulated the search for tests predictive of tumor response in order to more accurately select patients who may benefit from such a long, risky in terms of side effects, and costly therapy. Several mechanisms have been reported to be involved in the multidrug resistance resistance (MDR) to many of the currently used chemotherapeutic drugs and specific proteins have been demonstrated to be over expressed in these tumor cells. The most important seems to be a membrane transporter, P-glycoprotein (Pgp), product of the MDR1 gene in man. Like the other members of that family, it can actively extrude a wide variety of substrates from the cells, among which anthracyclines as well as other small lipophilic cations. Drugs called reversers are able to block the efficacy of these transmembrane resistance mechanisms. In patients with a tumor resistant to chemotherapy, such a reverser could make the tumor sensitive to chemotherapy. However, up to now, most of the reversers have not yet demonstrated their clinical efficacy, often because of their side effects. Since resistance to chemotherapy as well as the possible efficacy of a reverser are processes that take months before becoming evident either clinically or by conventional imaging, any technique that could detect these effects during the early phase of the treatment or, even better, that could predict the outcome would save lives, time and money. The radiopharmaceutical hexakis (2-methoxyisobutylisonitrile) technetium ( 99m Tc-sestamibi), which has been initially registered for myocardial blood flow imaging, then for breast cancer imaging, is an

An unusual accumulation of technetium-99m-sestamibi (99mTc-MIBI) mimicking an ectopic hyperfunctioning parathyroid tissue: usefulness of CT/SPECT technology in a single device

International Nuclear Information System (INIS)

Kienast, O.; Traub, T.; Dobrozemsky, G.; Dudczak, R.; Kurtaran, A.; Kletzmayr, J.; Kainberger, F.

2002-01-01

Full text: 99mTc-MIBI dual phase scintigraphy is a well established imaging modality in detecting hyperfunctioning parathyroid tissue. The authors report a case of 99mTc-MIBI scintigraphy showing MIBI-accumulation in projection of the upper mediastinum suspicious for hyperfunctioning parathyroid tissue. Further anatomical localization achieved by combined CT/SPECT technology revealed no mediastinal mass. A 71-year-old man with renal transplantation following chronic renal failure experienced hypercalcemia, hyperphosphatemia and elevation of serum parathyroid hormone levels. Ultrasonography of the neck revealed no enlarged parathyroid glands and further diagnostic work-up has been performed. A 99mTc-MIBI dual phase scintigraphy showed no abnormal accumulation in the typical parathyroid region but a focal activity in projection of the upper mediastinum was detected. The SPECT imaging of the neck and upper chest showed the accumulation in anterior location. This finding was interpreted as an ectopic (mediastinal) hyperfunctioning parathyroid tissue. In order to localize the focus, a CT/SPECT study with a single device system (GE Medical Systems Millennium VG gamma camera with Hawkeye) was done. This is an imaging system composed of a low current x-ray tube and a set of detectors mounted onto the camera's slip ring gantry. On registered and fused anatomical/functional images (CT/99mTc-MIBI SPECT), the increased accumulation of 99mTc-MIBI was shown to be an accumulation in the upper sternum. Further radiological examination revealed no abnormality in the sternum. This case illustrates the usefulness of the combined CT/SPECT imaging strategy with a single device in preventing unnecessary diagnostic/therapeutic interventions in patients with hyperthyroidism and abnormal 99mTc-MIBI scintigraphy. (author)

Usefulness of L,L-ethylenedicysteine - 99mTc complex (EC-99mTc) for the kidney investigations

International Nuclear Information System (INIS)

Surma, M.J.; Wiewiora, J.; Kapuscinksi, J.; Liniecki, J.

1992-01-01

To assess the usefulness of own EC- 99m Tc complex for the kidney function examination, the renoscintigraphy with EC- 99m Tc and clearance determinations were performed. During renoscintigraphy the kidney images were of superb quality, with overlaying organs (liver, spleen) not visualized. Renograms showed typical shapes, their TMAX and T1/2 values being insignificantly different from the obtained with other radiopharmaceuticals, used in renoscintigraphy (MAG 3 , hippuran). Very strict correlations were found between values of EC- 99m Tc and OIH- 131 I clearances (r=0.91) and excretion rate constants (r=0.92) of both radiopharmaceuticals. The correlation enabled formulation of an equation by which ERPF could be established from EC- 99m Tc clearance: ERPF OIH =1.245 x Cl EC +51.52. On the basis of this equation a lower boundary of the normal EC- 99m Tc clearance was established; it amounts to 300 ml/min/1.73 m 2 . (author). 17 refs, 5 figs, 1 tab

Differential effects comparing exercise and pharmacologic stress on left ventricular function using gated Tc-99m sestamibi SPECT

International Nuclear Information System (INIS)

Ohtaki, Yuka; Chikamori, Taishiro; Igarashi, Yuko; Hida, Satoshi; Tanaka, Hirokazu; Hatano, Tsuguhisa; Usui, Yasuhiro; Miyagi, Manabu; Yamashina, Akira

2008-01-01

Although post-ischemic stunning has emerged as an important marker for severe coronary artery disease (CAD), differences in stress methods may have different effects on left ventricular (LV) volumes and function. To assess differential effects comparing exercise and pharmacologic stress on the LV measurements, 99m Tc-sestamibi gated single-photon emission computed tomography (SPECT) acquired more than 30 min after stress and at rest was evaluated in 38 patients undergoing adenosine triphosphate (ATP) stress (ATP group) and 38 age- and sex-matched patients subjected to exercise stress (Ex group) among 268 patients with normal SPECT findings. Coronary risk factors and LV volumetric measurements at baseline were similar in the two groups. Compared with volumetric measurements at rest, end-diastolic volume (EDV) increased (72±21 ml to 74±21 ml; P=0.01), end-systolic volume increased (25±12 ml to 28±13 ml; P=0.001), and ejection fraction (EF) decreased after stress (66%±8% to 63%±9%; P<0.002) in the ATP group. In the Ex group, by contrast, no such change was observed. In addition, changes in EDV (3±6 vs. -1±5 ml; P=0.01) and the stress-to-rest ratio of EDV (1.04±0.09 vs. 0.99±0.08; P<0.02) after stress were greater in the ATP than in the Ex group. Differential effects of stress methods on LV volumes persist more than 30 min after the stress. These findings should be kept in mind when interpreting post-ischemic stunning. (author)

Comparative biological evaluation between 99mTc tricarbonyl and 99mTc-Sn(II) levosalbutamol as a β2-adrenoceptor agonist

International Nuclear Information System (INIS)

Sanad, Mahmoud H.; Borai, Emad H.

2015-01-01

This study describes the comparison between 99m Tc-tricarbonyl and 99m Tc-Sn (II) levosalbutamol as a β 2 -adrenoceptors radiopharmaceutical and evaluation of their different biological characteristics using experimental animals. Levosalbutamol was labeled firstly with 99m Tc in the presence of SnCl 2 . 2H 2 O as a reducing agent under the optimum conditions: pH 8, 50 μg SnCl 2 . 2H 2 O, room temperature, 40 μg levosalbutamol and 30 min reaction time to give a maximum radiochemical yield of 98 ± 0.1%. The obtained 99m Tc-levosalbutamol was stable for a time up to 8 h. Secondly, 99m Tc-tricarbonyl ([ 99m Tc(CO) 3 (H 2 O) 3 ] + ) levosalbutamol was prepare under 30 min heating at 100 C. Labeling yield and stability were analyzed by high performance liquid chromatography (labeling yield >99% and stability for 8 h). Biodistribution investigation showed that, the maximum uptake ratio of the 99m Tc-levosalbutamol ( 99m Tc-Lev) between lung and heart was 2.34 ± 0.62 % of the injected activity/g tissue organ, at 30 min post-injection. But in case of 99m Tc-tricarbonyl levosalbutamol ( 99m Tc-tricarbonyl Lev) the maximum uptake ratio was 3.6 ± 0.11 of the injected activity/g tissue organ, at 30 min post-injection. This indicates that 99m Tc-tricarbonyl levosalbutamol was more selective for lung β 2 -adrenoceptors than 99m Tc-levosalbutamol. These results introduce 99m Tc-tricarbonyl levosalbutamol as a novel potential radiopharmaceutical for lung imaging.

Achalasia diagnosed by {sup 99m}Tc pertechnetate scintigraphy; Diagnose einer Achalasie durch {sup 99m}Tc-Pertechnetat-Szintigraphie

Energy Technology Data Exchange (ETDEWEB)

Mikosch, P. [Landeskrankenhaus Klagenfurt (Austria). Abt. fuer Nuklearmedizin und Spezielle Endokrinologie; Gallowitsch, H.J. [Landeskrankenhaus Klagenfurt (Austria). Abt. fuer Nuklearmedizin und Spezielle Endokrinologie; Kresnik, E. [Landeskrankenhaus Klagenfurt (Austria). Abt. fuer Nuklearmedizin und Spezielle Endokrinologie; Lind, P. [Landeskrankenhaus Klagenfurt (Austria). Abt. fuer Nuklearmedizin und Spezielle Endokrinologie

1997-06-01

A 73-year-old patient presented a {sup 99m}Tc scintiscan with a focal tracer accumulation left and caudal of the thyroid gland. Further investigations with sonography, CT, esophagoscopy and barium swallow provided the diagnosis of achalasia as the reason for focal {sup 99m}Tc retention caudal of the thyroid gland. Explanation for {sup 99m}Tc accumulation within the esophagus may be the nonspecific accumulation of {sup 99m}Tc not only in the thyroid gland but also in the salivary glands. Excretion of the tracer follows with the saliva. Structural and motor disorders of the esophagus can thus lead to focal tracer retention within the esophagus simulating thyroid tissue. (orig.) [Deutsch] Eine 73jaehrige Patientin zeigte bei der {sup 99m}Tc-Schilddruesenszintigraphie eine von der Schilddruese abgesetzte deutliche fokale Speicherung links kaudal der Schilddruese. Die weitere diagnostische Abklaerung mittels Sonographie, CT, Oesophagoskopie und videoassistiertem Kontrastmittelschluckakt ergab als Ursache der {sup 99m}Tc-Speicherung eine Achalasie. Die Erklaerung einer {sup 99m}Tc-Speicherung in der Speiseroehre waere die unspezifische {sup 99m}Tc-Aufnahme in den Speicheldruesen mit nachfolgender Tracerelimination ueber den Speichel. Depotbildungen von Speichel bei Erkrankungen der Speiseroehre, die mit einer Transportstoerung des Speichels verbunden sind, koennen dadurch Schilddruesengewebe vortaeuschen. (orig.)

Diversification of 99Mo/99mTc separation: non–fission reactor production of 99Mo as a strategy for enhancing 99mTc availability.

Science.gov (United States)

Pillai, Maroor R A; Dash, Ashutosh; Knapp, Furn F Russ

2015-01-01

This paper discusses the benefits of obtaining (99m)Tc from non-fission reactor-produced low-specific-activity (99)Mo. This scenario is based on establishing a diversified chain of facilities for the distribution of (99m)Tc separated from reactor-produced (99)Mo by (n,γ) activation of natural or enriched Mo. Such facilities have expected lower investments than required for the proposed chain of cyclotrons for the production of (99m)Tc. Facilities can receive and process reactor-irradiated Mo targets then used for extraction of (99m)Tc over a period of 2 wk, with 3 extractions on the same day. Estimates suggest that a center receiving 1.85 TBq (50 Ci) of (99)Mo once every 4 d can provide 1.48-3.33 TBq (40-90 Ci) of (99m)Tc daily. This model can use research reactors operating in the United States to supply current (99)Mo needs by applying natural (nat)Mo targets. (99)Mo production capacity can be enhanced by using (98)Mo-enriched targets. The proposed model reduces the loss of (99)Mo by decay and avoids proliferation as well as waste management issues associated with fission-produced (99)Mo.

Triamide mercaptide (N/sub 3/S) ligands for Tc-99m as potential Tc-99m renal function agents

International Nuclear Information System (INIS)

Fritzberg, A.R.; Kasina, S.; Johnson, D.L.; Eshima, D.

1985-01-01

A number of diamide dimercaptide (N/sub 2/S/sub 2/) complexes of Tc-99m have shown potential as renal tubular function radiopharmaceuticals that could replace radioiodinated hippurate (OIH). Evaluation of such ligands suggested that maximum efficiency for tubular secretion and specificity resulted from addition of a carboxylate group. However, such derivatives resulted in chelate ring stereoisomers that were differently transported by the renal tubular system. The problem of stereoisomers was obviated by replacing one sulfur with an effectively planar amido nitrogen. Groups on the nitrogen then result in diastereomers only when an additional asymetric center is present. A series of triamide mercaptide compounds have been synthesized to evaluate this class as ligands for Tc-99m. One of the simplest of the series, mercaptoacetylglycylglycylglycine (MAG/sub 3/), formed a single Tc-99m product in high yield as determined by HPLC. Preliminary results with pmr and ms of the Tc-99 complex indicate a structure consistent with a 1:1 metal to ligand ratio and monooxo technetium group. Biological evaluation of Tc-99m MAG/sub 3/ showed high renal specificity and rate of excretion exceeding OIH in several species including humans. Members of the N/sub 3/S series studied include mercaptoacetylglycylglycyl-amino acids. In some cases with second asymmetric centers, two components were seen on HPLC. In mice several dianionic Tc-99m complexes were excreted faster than OIH, Tc-99m MAG/sub 2/-ala, -asn, and -gln. Trianionic Tc-99m MAG/sub 2/-asp and -glu were excreted more slowly, and Tc-99m MAG/sub 2/-phe showed hepatobiliary excretion. Triamide mercaptides represent a new ligand class for Tc-99m

Clinical comparison of diisopropyl-IDA Tc 99m and diethyl-IDA Tc 99m for evaluation of the hepatobiliary system

International Nuclear Information System (INIS)

Klingensmith, W.C.; Fritzberg, A.R.; Spitzer, V.M.; Kuni, C.C.; Shanahan, W.S.

1981-01-01

Thirty-one patients with a wide range of hepatobiliary function and clinical diagnoses were studied with both diisopropyl-IDA Tc 99m and diethyl-IDA Tc 99m. Images were similar except for an increased liver-to-kidney ratio with diisopropyl-IDA Tc 99m (p less than 0.01) and a tendency toward an increased liver-to-background ratio at five minutes with diisopropyl-IDA Tc 99m (p greater than 0.05). Quantification of the relative hepatocyte extraction efficiency indicated a 16% higher extraction efficiency for diisopropyl-IDA Tc 99m (p greater than 0.05). Cumulative three-hour urine collections following injection demonstrated no significant difference in renal excretion in patients with normal total serum bilirubin levels. Both radiopharmaceuticals demonstrated increasing renal excretion with increasing total serum bilirubin levels; however, renal excretion of diisopropyl-IDA Tc 99m increased more slowly than excretion of diethyl-IDA Tc 99m (p less than 0.01). We conclude that, while the overall differences between these two radiopharmaceuticals are small, diisopropyl-IDA Tc 99m is superior because of a lower renal excretion rate in patients with decreased hepatocyte function

Hyperfunctioning parathyroid tumours in patients with thyroid nodules. Sensitivity and positive predictive value of high-resolution ultrasonography and 99mTc-sestamibi scintigraphy.

Science.gov (United States)

Lumachi, F; Marzola, M C; Zucchetta, P; Tregnaghi, A; Cecchin, D; Bui, F

2003-09-01

A series of 112 consecutive patients with primary hyperparathyroidism who underwent both high-resolution neck ultrasonography (US) and 99mTc-sestamibi/99mTc-pertechnetate subtraction scintigraphy (SS) prior to successful parathyroidectomy was reviewed. There were 29 (25.9%) men and 83 (74.1%) women, with a median age of 58 years (range 13-78 years). Patients were divided into two groups, according to the preoperative US findings: group A (87 patients, 77.7%) without thyroid diseases, and group B (25 patients, 22.3%) with either multinodular goitre or a solitary nontoxic thyroid nodule. In group B patients partial or total thyroidectomy was also performed, according to the intraoperative findings and frozen-section examination results. Final histopathology showed 99 (88.4%) solitary parathyroid (PT) adenomas and 3 (2.7%) PT carcinomas, while 10 (8.9%) patients had a multiglandular disease. The sensitivity and positive predictive value (PPV) were (group A vs group B) 79.8% vs 70.8% (P=0.25) and 95.7% vs 94.4% (P=0.58) for US, and 83.3% vs 87.0% (P=0.47) and 95.9% vs 90.9% (P=0.32) for SS respectively. Better but similar (P=not significant) results were obtained in patients with solitary PT tumours: 81.5% vs 77.8% (US) and 85.0 vs 94.1% (SS) sensitivity; 97.1% vs 93.3% (US) and 95.8% vs 88.9% (SS) PPV. Overall, the combination of US and SS was 92.9% sensitive (group A=93.1%, group B=92.0%; P=0.55), and the PPV reached 100% in each group. In conclusion, in patients with primary hyperparathyroidism the results of both US and SS are independent of coexistent thyroid disease, especially in patients with solitary PT tumours.

Myocardial 99mTc-sestamibi extraction and washout in hypertensive heart failure using an isolated rat heart

International Nuclear Information System (INIS)

Fukushima, Kenji; Momose, Mitsuru; Kondo, Chisato; Higuchi, Takahiro; Kusakabe, Kiyoko; Hagiwara, Nobuhisa

2010-01-01

Purpose: Myocardial mitochondria are the primary part of energy production for healthy cardiac contraction. And mitochondrial dysfunction would play an important role in progressive heart failure. In the recent years, myocardial washout of 99m Tc-sestamibi [( 99m Tc-hexakis-2-methoxy-2-methylpropyl isonitrile (MIBI)] has been introduced to be a potential marker in patients with heart failure. The objective of this study was to clarify MIBI extraction and washout kinetics using isolated perfusion system in hypertension induced model of myocardial dysfunction. Methods: Six-week-old Dahl-salt sensitive rats, allotted to 4 groups; a 5-week high-salt group (5wk-HS), 12-week high-salt group (12wk-HS) and two age-matched, low-salt diet control groups (5wk-LS and 12wk-LS). The rats in 5wk-HS and 12wk-HS groups were fed a high-salt diet (containing 8% NaCl). Cardiac function was examined by echocardiography before removing heart. Hearts were perfused according to the Langendorff method at a constant flow rate, in which 20-min MIBI washin was conducted followed by 25-min MIBI washout. Whole heart radioactivity was collected every sec by an external gamma detector. The myocardial extraction, K 1 (ml/min) and washout rate, k 2 (min -1 ) were generated. Results: High-salt diet groups showed significant high-blood pressure. Echocardiography revealed thickened LV walls in 5wk-HS, and reduced cardiac function in 12wk-HS, compared to each age-matched control group. K 1 showed no significant difference among all groups (5wk-HS: 2.36±1.07, 5wk-control: 2.59±0.28, 12wk-HS: 1.91±0.90, and 12wk-control: 2.84±0.57). k 2 in 5wk-HS was comparable to that in the age matched control group (0.00030±0.00039 vs -0.000010±0.00044), but it was increased remarkably in 18wk-HS compared to the age matched control group (0.0025±0.0011 vs 0.000025±0.000041, P<.01), and 5wk-HS (P<.01). Conclusion: In the course of hypertensive heart disease, MIBI washout was increased in the transitional state

Ventilation scintigraphy of the lung with sup(99m)Tc-DTPA or with sup(99m)Tc-sulfur colloid

Energy Technology Data Exchange (ETDEWEB)

Koehler, D; Matthys, H; Coates, G; Dolovich, M; Newhouse, M

1983-04-01

Ventilation scintigraphy of the lung, obtained with sufficiently small sup(99m)Tc-labelled aerosol particles, provides an image of ventilation distribution that is acceptable in clinical routine. Whether sup(99m)Tc-DTPA or sup(99m)Tc-sulfur colloid is more suitable as a carrier was studied in 6 smokers and 8 non-smokers with chronic obstructive pulmonary disease. sup(99m)Tc-sulfur colloid was not absorbed by the bronchial mucosa and therefore appears to be an almost ideal agent. In contrast, sup(99m)Tc-DTPA was absorbed by the bronchial mucosa in all smoking patients more rapidly and inhomogenously than in non-smokers. The quantitative and qualitative comparison of the two dorsal ventilation scans taken both immediately after inhalation and 20 min later, showed in all 6 smoking patients after 20 min significant differences which influenced the diagnostic result. sup(99m)Tc-DTPA is therefore not recommended for use in ventilation lung scintigraphy, especially in smoking patients.

Assessment of the direct cyclotron production of (99m)Tc: An approach to crisis management of (99m)Tc shortage.

Science.gov (United States)

Rovais, Mohammad Reza Aboudzadeh; Aardaneh, Khosro; Aslani, Gholamreza; Rahiminejad, Ali; Yousefi, Kamran; Boulouri, Fatemeh

2016-06-01

Nowadays, the cyclotron production of technetium-99m ((99m)Tc) has been increased, due to the worldwide (99m)Tc generator shortage. In the present work, an improved strategy for the production of (99m)Tc, using the proton irradiation of the enriched (100)Mo was developed. The performance of this method in terms of the production yield, chemical purity, radiochemical purity, as well as radionuclide purity was evaluated. The average production yield was measured to be 356MBqμA(-1)h(-1). A good agreement was found between the calculated production yield and the experimental one. The radiochemical separation and total recovery yields of (99m)Tc were 92% and 69%, respectively. The radiochemical and the radionuclide purities of the (99m)Tc were 99% and >99.99% at the end of purification, respectively. The results of quality control tests (QC) support the concept that cyclotron-produced (99m)Tc is suitable for preparation of USP-compliant. Copyright © 2016 Elsevier Ltd. All rights reserved.

Quality assurance of Mo-99/Tc-99m radionuclide generators

Science.gov (United States)

Uzunov, Nikolay; Yordanova, Galina; Salim, Seniha; Stancheva, Natalya; Mineva, Vanya; Meléndez-Alafort, Laura; Rosato, Antonio

2018-03-01

Gamma-ray spectrometry analyses of the radionuclide content of eluate from two Mo-99/Tc-99m radionuclide generators POLTECHNET have been performed. The relative activities of 99Mo 103Ru and 131I radioisotopes with respect to the activity of 99mTc at different time intervals after the primary pertechnetate elution of the generators have been analyzed. The relative activities of the isotopes were determined and compared to the radionuclidic purity requirements for 99mTc.

Correlation between differential renal uptake of 99mTc-MAG3 and 99mTc-DMSA

International Nuclear Information System (INIS)

Obaldo, J.M.; Gruenwald, F.; Menzel, C.; Biersack, H.J.

1994-01-01

We reviewed the quantitative indices obtained from sequential 99m Tc-MAG3 and 99m Tc-DMSA imaging studies performed in 134 patients with a variety of renal disorders in order to determine the correlation between the measured differential renal function using these two agents. Overall correlation was high with r=.86 and the derived regression equation was R.F. DMSA =8.2+0.84 (R.F. MAG3 ), where F.F. is the relative function. Highly divergent values for differential function were obtained however in some subjects. Patients with renal obstructive disorders had a correlation coefficient of.81 which was lower than those with nonobstructive pathologies (r=.95). Although relative kidney function measured using 99m Tc-MAG3 and 99m Tc-DMSA correlate significantly, certain patients such as those with renal obstruction may necessitate quantitation using different renal parameters. (orig.) [de

The evaluation of usefulness of quantitative analysis method with {sup 99m}Tc-tetrofosmin on effective dicision of reperfusion therapy to acute myocardial infarction

Energy Technology Data Exchange (ETDEWEB)

Takagi, Hitoshi; Sone, Takahito [Ogaki Municipal Hospital, Gifu (Japan)

1998-01-01

SPECT on acute and chronic period of {sup 99m}Tc-tetrofosmin on 46 patients with acute myocardial infarction were analyzed to evaluate about usefulness of quantitative analysis method used by unfolding image that was gotten by Bull`s eye analysis on reperfusion therapy in acute myocardial infarction, and we could get undermentioned results. 60% black out area in resional of interested was best on the obstacle myocardium using analysis of unfolding image. Significantly betterment from acute to chronic phase on the obstacle area of myocardium and the mean uptake ratio of the obstacle area was confirmed by this method. The relation between myocardial salvage and factors of myocardial damage, for example reperfusion time TIMI grade, rentrop grade and reperfusion phenomenon could be analyzed by this method. This method was suspected to underestimate the areas of obstacle myocardium on the cases of defect of apex. Error of analysis was suspected on the case of accumulation of TF to other than myocardium. The problems were minimised by some techniques mention in this paper. (author)

Development of 99mTc-ethyl cysteinate dimer (Neurolite) for imaging brain blood flow in stroke and other disorders

International Nuclear Information System (INIS)

Liteplo, M.P.

1992-01-01

Compounds labeled with 99m Tc are widely used for imaging in diagnostic medicine to provide information on physiological functions of the body not obtainable with other imaging techniques that give primarily anatomical information, such as X-ray and magnetic resonance imaging. These radiopharmaceuticals are typically injected intravenously and allowed to distribute in the body; the patient is then imaged using a scintillation gamma camera. For example, in patients suspected of coronary artery disease, 99m Tc-Sestamibi (Cardiolite reg-sign) is injected into the blood stream during a stress test and is rapidly extracted by the heart muscle in proportion to its regional blood supply. The resulting images of the heart clearly distinguish areas of normal heart muscle form areas where the blood supply is compromised by coronary artery disease. In recent years, there has been considerable interest in the application of 99m Tc compounds to the diagnosis of brain diseases and disorders. This paper describes the development of 99m Tc-ethyl cysteinate dimer ( 99m Tc-ECD, Neurolite reg-sign) as a radiopharmaceutical for imaging the blood supply to the brain in patients with stroke or head trauma. In research, this agent is also useful in studying the effect of sensory stimuli, therapeutic drugs, and drugs of abuse on brain blood flow

Determination of radiochemical purity and pharmacokinetic parameters of sup(99m)Tc-sulphur colloid and sup(99m)Tc-tin colloid

International Nuclear Information System (INIS)

Jovanovic, V.; Konstantinovska, D.; Milivojevic, K.; Bzenic, J.

1981-01-01

Labelling yield and radiochemical purity, higher than 95%, of sup(99m)Tc-colloid preparations were determined by using the paper chromatography method. Less than 3% of labelled citric acid, added to the preparation as a buffer solution, has been found in sup(99m)Tc-sulphur colloid. High radiochemical purity and optimum size of colloid particles has also been proved by biodistribution studies on experimental animals. The analysis performed has shown that more than 50% of sup(99m)Tc-colloid preparations excreted by urine is sup(99m)TcO - , the remaining past 50% being protein bound sup(99m)Tc. Biological half-time of excretion of the fast phase is the same for both preparations, i.e. 10 min, while for the slow component it is 120 min in sup(99m)Tc-S-colloid and 160 min in sup(99m)Tc-Sn colloid. (orig.) [de

Comparative study of uptake and washout of 99mTcN(NOEt)2 with 99mTc-MIBI in human cervical carcinoma cell lines

International Nuclear Information System (INIS)

Xing Shi'an; Zhang Yongxue; An Rui

2002-01-01

Objective: to investigate the cellular kinetics of bis (N-ethoxy-N-ethyl dithiocarbamato) nitrido 99m Tc(V) [ 99m TcN (NOEt) 2 ] in human cervical carcinoma cell line Hela and to compare it with that of 99m Tc hexakis-2- methoxyisobutyl isonitrile ( 99m Tc-MIBI), and hence to define the possible clinical value of 99m TcN(NOEt) 2 in tumor imaging. Methods: Using radionuclide tracer technique, 99m TcN(NOEt) 2 and 99m Tc-MIBI were incubated with human cervical carcinoma cell lines Hela at 37 degree C and at 22 degree C respectively. At several incubation times, the uptake and washout characteristics of the radiotracers in human cervical carcinoma cell line Hela were investigated and compared. Results: The maximum uptake of 99m TcN(NOEt) 2 in Hela was 46.15% and that of 99m Tc-MIBI was 12.6% (P 99m TcN(NOEt) 2 after 5 min incubation in human cervical carcinoma cell line Hela was 65% of the total uptake, while that of 99m Tc-MIBI was 50% of the total uptake (P 99m TcN(NOEt) 2 was retained in the Hela cells at one hour while 56.67% of 99m Tc-MIBI was retained (P 99m Tc-MIBI, the cellular kinetics of 99m TcN(NOEt) 2 was not temperature-dependent (the cellular kinetics is similar at 37 degree C and at 22 degree C, P>0.05). Conclusions: In vitro data suggest that 99m TcN(NOEt) 2 may be a better tracer than 99m Tc-MIBI in tumor imaging and 99m TcN(NOEt) 2 has potential application in clinical use

Pharmacological study of 99mTc-CO-MIBI, a new mycoardial perfusion imaging agent comparison to 99mTc-MIBI

International Nuclear Information System (INIS)

Zhao Jiandong; Wang Jincheng; Mi Hongzhi

2004-01-01

For many years, 99m Tc-MIBI has been widely used for the diagnosis of ischemic heart disease. Although it has been regarded as a successful myocardial imaging agent, it has a notable defect of high liver radioactivities due to high uptake and slowly excrete. Recently, researchers had developed a new intermediate [ 99m Tc(CO) 3 (OH 2 ) 3 ] + , considering 99m Tc-MIBI excellent biodistribution, they synthesized a new class of compound- 99m Tc-CO-MIBI with [ 99m Tc(CO) 3 ] + core and ligand MIBI. Previous studies have preliminary demonstrated the following favorable properties: rapid blood-pool clearance, high myocardial extraction and rapid clearance kinetics from liver that indicated 99m Tc-CO-MIBI a promising new myocardial perfusion imaging agent. Furthermore, researchers separated the compound by changing liquid pH value and prepared single alkaline component 99m Tc-CO-MIBI. The pharmacological experiments in rat have provided better results on its biodistribution in vivo and much faster clearance kinetics from liver compared to 99mTc-MIBI. To evaluate the potential application of 99m Tc-CO-MIBI, further investigations are necessary to determine the evidence for enhanced ability in clinical decision making as a novel new myocardial perfusion imaging agent. Objective: Here, perform pharmacological experiment of 99m Tc-CO-MIBI, a new technetium-99m-labeled myocardial imaging agent compared to 99m Tc-MIBI in canines. To identify whether it is feasible in clinical application as a novel myocardial imaging agent, or not. Results: Accordingly, prepared the single alkaline component of 99m Tc-CO-MIBI. The complex was stable up to at least 7 hours after synthesized in vitro at either room temperature or 37 degree C water bath. Labeling yield and radiochemical purity (RCP) of the complex were evaluated by TLC and HPLC, the labeling percent was 93%-97% and the RCP was over 90%. Then administer 555MBq to every dog each times. A total of 5 dogs were involved. The data of

Peptic ulcer imaging with /sup 99m/Tc sucralfate and possible advantages of /sup 99m/Tc sucrose octasulfate

International Nuclear Information System (INIS)

CentiColella, A.; Scopinaro, F.

1986-01-01

Sucralfate is a basic aluminum salt of sucrose octasulfate that protects the damaged mucosa and also the normal mucosa from peptic aggression. In fact sucralfate adheres to the mucosa as pH decreases below 4, and buffers the acid, slowly releasing sucrose octasulfate that forms insoluble complexes with the proteins exuded by the ulcers, or is washed out of the stomach. Sucralfate itself is also able to precipitate with proteins in the ulcers. Sucralfate may be labelled by several methods: /sup 99m/Tc HSA, /sup 99m/Tc DTPA, /sup 75/Se, /sup 111/In. The aims of this study were to evaluate the clinical results obtained using /sup 99m/Tc DTPA sucralfate, which the authors believe is the only labelled sucralfate suitable for clinical studies and to discuss the possible diagnostic uses of /sup 99m/Tc sucrose octasulfate. In fact, it has been possible to label the sucrose octasulfate either with /sup 99m/Tc DTPA or with /sup 99m/Tc without the use of intermediate ligands

Simultaneous acquisition of (99m)Tc- and (123)I-labeled radiotracers using a preclinical SPECT scanner with CZT detectors.

Science.gov (United States)

Kobayashi, Masato; Matsunari, Ichiro; Nishi, Kodai; Mizutani, Asuka; Miyazaki, Yoshiharu; Ogai, Kazuhiro; Sugama, Jyunko; Shiba, Kazuhiro; Kawai, Keiichi; Kinuya, Seigo

2016-05-01

Simultaneous acquisition of (99m)Tc and (123)I was evaluated using a preclinical SPECT scanner with cadmium zinc telluride (CZT)-based detectors. 10-ml cylindrical syringes contained about 37 MBq (99m)Tc-tetrofosmin ((99m)Tc-TF) or 37 MBq (123)I-15-(p-iodophenyl)-3R,S-methyl pentadecanoic acid ((123)I-BMIPP) were used to assess the relationship between these SPECT radioactive counts and radioactivity. Two 10-ml syringes contained 100 or 300 MBq (99m)Tc-TF and 100 MBq (123)I-BMIPP to assess the influence of (99m)Tc upscatter and (123)I downscatter, respectively. A rat-sized cylindrical phantom also contained both 100 or 300 MBq (99m)Tc-TF and 100 MBq (123)I-BMIPP. The two 10-ml syringes and phantom were scanned using a pinhole collimator for rats. Myocardial infarction model rats were examined using 300 MBq (99m)Tc-TF and 100 MBq (123)I-BMIPP. Two 1-ml syringes contained 105 MBq (99m)Tc-labeled hexamethylpropyleneamine oxime ((99m)Tc-HMPAO) and 35 MBq (123)I-labeled N-ω-fluoropropyl-2β-carbomethoxy-3β-(4-iodophenyl) nortropane ((123)I-FP-CIT). The two 1-ml syringes were scanned using a pinhole collimator for mice. Normal mice were examined using 105 MBq (99m)Tc-HMPAO and 35 MBq (123)I-FP-CIT. The relationship between SPECT radioactive counts and radioactivity was excellent. Downscatter contamination of (123)I-BMIPP exhibited fewer radioactive counts for 300 MBq (99m)Tc-TF without scatter correction (SC) in 125-150 keV. There was no upscatter contamination of (99m)Tc-TF in 150-175 keV. In the rat-sized phantom, the radioactive count ratio decreased to 4.0 % for 300 MBq (99m)Tc-TF without SC in 125-150 keV. In the rats, myocardial images and radioactive counts of (99m)Tc-TF with the dual tracer were identical to those of the (99m)Tc-TF single injection. Downscatter contamination of (123)I-FP-CIT was 4.2 % without SC in 125-150 keV. In the first injection of (99m)Tc-HMPAO and second injection of (123)I-FP-CIT, brain images and radioactive counts

Pulmonary clearance of 99mTc-DTPA and 99mTc-albumin in rabbits with surfactant dysfunction and lung injury

International Nuclear Information System (INIS)

Nilsson, K.; Wollmer, P.

1992-01-01

We measured the pulmonary clearance of inhaled 99m Tc-DTPA and 99m Tc-albumin in rabbits with surfacant dysfunction induced by dioctyl sodium sulphosuccinate and in rabbits with lung injury induced by oleic acid. After inhalation of 99m Tc-albumin in ten animals, clearance of the tracer from the lungs was monitored for 90 min. The first 30 min was a control period. Dioctyl sodium sulphosuccinate was then administered in aerosol and after another 30 min oleic acid was injected intravenously. Ten other rabbits were given 99m Tc-DTPA, and clearance was externally recorded for 60 min. Five animals inhaled detergent aerosol and five animals were given oleic acid intravenously after 30 min. Airway pressures, tidal volume, and arterial blood gases were measured before and after each intervention. The half-life of 99m Tc-albumin in the lung was 442 ± 123 min during the control period, 363 ± 52 min after detergent administration, and 134 ± 18 min after oleic acid administration. The half-life of 99m Tc-DTPA was 94 ± 16 min before and 10 ± 0.6 min after detergent administration and 75 ± 12 min before and 18 ± 1.8 min after oleic acid administration. Gas exchange was not affected by administration of dioctyl sodium sulphosuccinate but markedly impaired after injection of oleic acid. Compliance of the respiratory system remained unaffected by detergent but decreased after injection of oleic acid. The results indicate that the rate limiting factors for the alveolo-capillary transfer of 99m Tc-albumin and 99m Tc-DTPA are different. Surfactant dysfunction affects the transfer of 99m Tc-DTPA but not 99m Tc-albumin. (author)

Myocardial sestamibi single-photon emission tomography: variations in reference values with gender, age and rest versus stress?

International Nuclear Information System (INIS)

Toft, J.; Hesse, B.; Raboel, A.; Carstensen, S.; Ali, S.

1997-01-01

Reference data files support the evaluation of myocardial perfusion single-photon emission tomography (SPET). The aim of this study was to create a large reference data base for technetium-99m sestamibi SPET, age and gender matched to the general patient population. One hundred and twenty-eight healthy volunteers (76 males and 52 females) with a likelihood of coronary artery disease of less than 5% underwent rest and maximal exercise 99m Tc-sestamibi SPET with a 2-day protocol and 180 elliptical rotation. The normalized activity values of 99m Tc-sestamibi in the inferior wall differed significantly between men and women. Age variations were found for men in the anterior wall. Normalized activity values in all four walls were strikingly similar during rest and stress. Our results suggest that the use of reference files in 99m Tc-sestamibi SPET requires a gender- and, for males, possibly an age-matched reference population. Different reference files at rest and during stress might not be necessary. (orig.). With 3 figs., 3 tabs

Preparation, chromatographic evaluation and biodistribution of "9"9"mTc-procainamide as a radiopharmaceutical for heart imaging

International Nuclear Information System (INIS)

Motaleb, M.A.; Ibrahim, I.T.; Abo Rizq, R.S.; Elzanfaly, E.S.

2017-01-01

Procainamide (4-amino-N-[2-(diethylamino) ethyl] benzamide) is a sodium channel blocker, which acts as an effective antiarrhythmic agent used in the treatment of a variety of atrial and ventricular arrhythmias. The aim of this study was to prepare "9"9"mTc-procainamide complex, apply different chromatographic techniques for the assay of radiolabeling yield and study its biodistribution as a novel radiopharmaceutical for heart imaging. "9"9"mTc-procainamide was obtained with a maximum labeling yield of 95.76±0.20% via direct labeling method under optimum conditions of 200 μg of procainamide, 300 μL of buffer (carbonate) at pH 11, 30 μg SnCl_2 . 2H_2O at room temperature (25 C) for 15 min. In terms of in vitro stability, the complex was stable for 3 h. Chromatographic evaluation using paper chromatography, thin layer chromatography, gel chromatography, and high performance liquid chromatography showed reliable results for measuring the radiochemical yield. Biodistribution study of "9"9"mTc-procainamide showed ratios of heart/lung and heart/liver (6.38±1.50, 2.06±0.31, respectively at 30 min post injection) which was comparable to that of "9"9"mTc-sestamibi (7.4±2.00, 0.97±0.10, respectively at 60 min, P<0.05).

Preparation, chromatographic evaluation and biodistribution of {sup 99m}Tc-procainamide as a radiopharmaceutical for heart imaging

Energy Technology Data Exchange (ETDEWEB)

Motaleb, M.A.; Ibrahim, I.T.; Abo Rizq, R.S. [Atomic Energy Authority, Cairo (Egypt). Labeled Compound Dept.; Elzanfaly, E.S. [Cairo Univ. (Egypt). Analytical Dept.

2017-06-01

Procainamide (4-amino-N-[2-(diethylamino) ethyl] benzamide) is a sodium channel blocker, which acts as an effective antiarrhythmic agent used in the treatment of a variety of atrial and ventricular arrhythmias. The aim of this study was to prepare {sup 99m}Tc-procainamide complex, apply different chromatographic techniques for the assay of radiolabeling yield and study its biodistribution as a novel radiopharmaceutical for heart imaging. {sup 99m}Tc-procainamide was obtained with a maximum labeling yield of 95.76±0.20% via direct labeling method under optimum conditions of 200 μg of procainamide, 300 μL of buffer (carbonate) at pH 11, 30 μg SnCl{sub 2} . 2H{sub 2}O at room temperature (25 C) for 15 min. In terms of in vitro stability, the complex was stable for 3 h. Chromatographic evaluation using paper chromatography, thin layer chromatography, gel chromatography, and high performance liquid chromatography showed reliable results for measuring the radiochemical yield. Biodistribution study of {sup 99m}Tc-procainamide showed ratios of heart/lung and heart/liver (6.38±1.50, 2.06±0.31, respectively at 30 min post injection) which was comparable to that of {sup 99m}Tc-sestamibi (7.4±2.00, 0.97±0.10, respectively at 60 min, P<0.05).

sup(99m)Tc-Ethylenediamine-N, N-diacetic acid

International Nuclear Information System (INIS)

Imoto, Takeshi

1984-01-01

sup(99m)Tc-Ethylenediamine-N, N-Diacetic Acid (sup(99m)Tc-EDDA), a compound having affinity for tumors was evaluated, and the results were as follows. 1) sup(99m)Tc-EDDA accumulated in experimentary-induced tumors. The tumor/tissue ratio (%g/dose) of sup(99m)Tc-EDDA was greater than that of 67 Ga-citrate, especially with Ehrlich ascites tumors. 2) sup(99m)Tc-EDDA accumulated mainly in the nuclear components of tumor cells. 3) No acute toxic effects of EDDA were observed in mice, rabbits or in volunteers. 4) The sup(99m)Tc-EDDA image was positive in 72 % of clinical examinations of lung cancer. The sup(99m)Tc-EDDA did not accumulate in the liver, and this suggests that tumor near the liver may be more easily detected with sup(99m)Tc-EDDA than with 67 Ga-citrate. 5) In some cases sup(99m)Tc-EDDA accumulated in mammary glands (nipples) and in pleural effusions (pleuritis), though the mechanism of which was obscure. 6) sup(99m)Tc-EDDA is a good agent for detecting malignant tumors. (author)

Clinical evaluation of sup(99m)Tc-(Sn)-PI (sup(99m)Tc-(Sn)-pyridoxylidene isoleucine) in the various hepatobiliary disorders

Energy Technology Data Exchange (ETDEWEB)

Kawaguchi, S; Iio, M; Yamada, H; Murata, H; Chiba, K [Tokyo Metropolitan Geriatric Medical Center (Japan)

1978-12-01

The purpose of this study is to evaluate the hepatobiliary scanning using sup(99m)Tc-(Sn)-PI in clinical diagnosis of various hepatobiliary disorders. Nineteen patients were scanned with sup(99m)Tc-(Sn)-PI. The results were as follows: 1) The stability of sup(99m)Tc-(Sn)-PI examined by paper chromatography using saline as a solvent showed satisfied result at scanning time. sup(99m)Tc-(Sn)-PI in the blood was assumed to be bound to serum proteins immediately after injection. sup(99m)Tc-(Sn)-PI in the urine was assumed to keep the form of sup(99m)Tc-(Sn)-PI. 2) The appearance times of kidney, liver, bile duct, gallbladder, and intestine in the normal case were 5, 5, 10 and 15 minutes respectively after injection. The peak times of hepatogram in the normal case, drug induced hepatitis and obstructive jaundice were 12, 15 and 18 minutes respectively after injection. The images obtained by sup(99m)Tc-(Sn)-PI was superior to the images obtained by /sup 131/I-BSP. 3) The blood clearance and urinary excretion rate of sup(99m)Tc-(Sn)-PI also provided us clinical usefulness. 4) The scanning of Dubin-Johnson syndrome of sup(99m)Tc-(Sn)-PI showed almost normal hepatobiliary image similar to the sequential scan by /sup 131/I-RB as was reported previously by authors. In conclusion, the hepatobiliary scan using sup(99m)Tc-(Sn)-PI provided clear hepatobiliary images. Other parameters such as blood clearance, urinary excretion rate and diameter of choledochus were also favorable. By combining it with sup(99m)Tc-HIDA a differential diagnosis of congenital jaundice is also expected.

Clinical evaluation of sup(99m)Tc-(Sn)-PI [sup(99m)Tc-(Sn)-pyridoxylidene isoleucine] in the various hepatobiliary disorders

International Nuclear Information System (INIS)

Kawaguchi, Schinichiro; Iio, Masahiro; Yamada, Hideo; Murata, Hajime; Chiba, Kazuo

1978-01-01

The purpose of this study is to evaluate the hepatobiliary scanning using sup(99m)Tc-(Sn)-PI in clinical diagnosis of various hepatobiliary disorders. Nineteen patients were scanned with sup(99m)Tc-(Sn)-PI. The results were as follows: 1) The stability of sup(99m)Tc-(Sn)-PI examined by paper chromatography using saline as a solvent showed satisfied result at scanning time. sup(99m)Tc-(Sn)-PI in the blood was assumed to be bound to serum proteins immediately after injection. sup(99m)Tc-(Sn)-PI in the urine was assumed to keep the form of sup(99m)Tc-(Sn)-PI. 2) The appearance times of kidney, liver, bile duct, gallbladder, and intestine in the normal case were 5, 5, 10 and 15 minutes respectively after injection. The peak times of hepatogram in the normal case, drug induced hepatitis and obstructive jaundice were 12, 15 and 18 minutes respectively after injection. The images obtained by sup(99m)Tc-(Sn)-PI was superior to the images obtained by 131 I-BSP. 3) The blood clearance and urinary excretion rate of sup(99m)Tc-(Sn)-PI also provided us clinical usefulness. 4) The scanning of Dubin-Johnson syndrome of sup(99m)Tc-(Sn)-PI showed almost normal hepatobiliary image similar to the sequential scan by 131 I-RB as was reported previously by authors. In conclusion, the hepatobiliary scan using sup(99m)Tc-(Sn)-PI provided clear hepatobiliary images. Other parameters such as blood clearance, urinary excretion rate and diameter of choledochus were also favorable. By combining it with sup(99m)Tc-HIDA a differential diagnosis of congenital jaundice is also expected. (author)

Different uptake of {sup 99m}Tc-ECD and {sup 99m}Tc-HMPAO in the same brains: analysis by statistical parametric mapping

Energy Technology Data Exchange (ETDEWEB)

Hyun, I.Y. [Dept. of Nuclear Medicine, Inha University College of Medicine, Incheon (Korea); Lee, J.S.; Lee, D.S. [Dept. of Nuclear Medicine, Seoul National University College of Medicine, Seoul (Korea); Rha, J.H.; Lee, I.K.; Ha, C.K. [Dept. of Neurology, Inha University College of Medicine, Incheon (Korea)

2001-02-01

The purpose of this study was to investigate the differences between technetium-99m ethyl cysteinate dimer ({sup 99m}Tc-ECD) and technetium-99m hexamethylpropylene amine oxime ({sup 99m}Tc-HMPAO) uptake in the same brains by means of statistical parametric mapping (SPM) analysis. We examined 20 patients (9 male, 11 female, mean age 62{+-}12 years) using {sup 99m}Tc-ECD and {sup 99m}Tc-HMPAO single-photon emission tomography (SPET) and magnetic resonance imaging (MRI) of the brain less than 7 days after onset of stroke. MRI showed no cortical infarctions. Infarctions in the pons (6 patients) and medulla (1), ischaemic periventricular white matter lesions (13) and lacunar infarction (7) were found on MRI. Split-dose and sequential SPET techniques were used for {sup 99m}Tc-ECD and {sup 99m}Tc-HMPAO brain SPET, without repositioning of the patient. All of the SPET images were spatially transformed to standard space, smoothed and globally normalized. The differences between the {sup 99m}Tc-ECD and {sup 99m}Tc-HMPAO SPET images were statistically analysed using statistical parametric mapping (SPM) 96 software. The difference between two groups was considered significant at a threshold of uncorrected P values less than 0.01. Visual analysis showed no hypoperfused areas on either {sup 99m}Tc-ECD or {sup 99m}Tc-HMPAO SPET images. SPM analysis revealed significantly different uptake of {sup 99m}Tc-ECD and {sup 99m}Tc-HMPAO in the same brains. On the {sup 99m}Tc-ECD SPET images, relatively higher uptake was observed in the frontal, parietal and occipital lobes, in the left superior temporal lobe and in the superior region of the cerebellum. On the {sup 99m}Tc-HMPAO SPET images, relatively higher uptake was observed in the medial temporal lobes, thalami, periventricular white matter and brain stem. These differences in uptake of the two tracers in the same brains on SPM analysis suggest that interpretation of cerebral perfusion is possible using SPET with {sup 99m}Tc-ECD and

Bioavailability of {sup 99m}Tc-paclitaxel-glucuronide ({sup 99m}Tc-PAC-G)

Energy Technology Data Exchange (ETDEWEB)

Biber Muftuler, F.Z.; Demir, I.; Uenack, P.; Ichedef, C.; Yurt Kilcar, A. [Ege Univ., Izmir (Turkey). Dept. of Nuclear Applications

2011-07-01

An antitumor agent paclitaxel (PAC) has been proved to be efficient in the treatment of breast and ovarian cancer. Glucuronic acid-derived paclitaxel compound (paclitaxel-glucuronide (PAC-G)) was enzymatically synthesized using microsome preparate separated from rat livers. The biodistribution mechanism of PAC-G in healthy female Albino Wistar rats has been investigated. The expected structure is confirmed according to LC/MS results, and the possible attachment is to C2-hydroxyl group. PAC-G was labeled with {sup 99m}Tc and the radiochemical yield of radiolabeled compound ({sup 99m}Tc-PAC-G) was 98.0 {+-} 02.74% (n=9). The range of the breast/blood and breast/muscle ratios is approximately between 3 and 35 in 240 min. All these experimental studies indicate that {sup 99m}Tc-PAC-G may potentially be used in breast tissue as an imaging agent. (orig.)

Development of 99Mo/99mTc Generator System for Production of Medical Radionuclide 99mTc using a Neutron-activated 99Mo and Zirconium Based Material (ZBM as its Adsorbent

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I. Saptiama

2016-12-01

Full Text Available Molybdenum produced from fission of U-235 is the most desirable precursor for 99Mo/99mTc generator system as it is non-carrier added and has high specific activity. However, in the last decade there has been short supply of 99Mo due to several constrains. Therefore, there have been many works performed for development of 99Mo/99mTc generator system using 99Mo which is not produced from either LEU or HEU. This report deals with development of 99Mo/99mTc generator system where zirconium-based material (ZBM is used as adsorbent of neutron-activated 99Mo. The system was prepared by firstly irradiating natural Mo in the G. A. Siwabessy reactor to produce neutron-activated 99Mo. The target was dissolved in NaOH 4N and then neutralized with 12 M HCl. The 99Mo solution was then mixed with a certain amount of ZBM followed by heating at 90°C for three hours to allow the 99Mo adsorbed on ZBM. The 99Mo-ZBM (9.36 GBq of 99Mo was Mo/ 4.2 g ZBM was packed on a fritz-glass column. This column was then fitted serially with an alumina column for trapping 99Mo breakthrough. The columns were then eluted daily with saline solution for up to one week. The yield of 99mTc was found to be between 53.7 – 74% (n= 5. All 99mTc eluates were clear solutions with pH of 5. Breakthrough of 99Mo in 99mTc eluates was found to be 0.031 ± 0.019 μCi 99Mo/ mCi 99mTc (n= 5 which was less than the maximum activity of 99Mo allowed in 99mTc solution ( 99%. Radiolabeling of this 99mTc towards methylene diphosphonate (MDP kit gave a radiolabelling efficiency of 99%. In summary, a new 99Mo/99mTc generator system that used neutron-activated 99Mo and ZBM as its adsorbent has been successfully prepared. The 99mTc produced from this new 99Mo/99mTc generator system attained the quality of 99mTc required for medical purposes.

Pharmaceutical design and pharmacological characterization of Tc99m [99mTc] labelled somatostatin and gastrin analogues